Ep. 3: Our Social Frameworks | Abdesalam Soudi

In episode 3 of Speaking of Us, Kristen and Daniel talk with Dr. Abdesalam Soudi, professor of linguistics at the University of Pittsburgh. They cover a diverse set of topics: creating positive language environments for children, the acts of conversational cues, and the importance of words in a medical setting.

This is a transcript of Episode 3 of “Speaking of Us”. To listen to this episode, visit Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy it, please leave a review and subscribe for new episodes! Thanks to Cara Judkins and Kristen Tcherneshoff for transcribing this episode.

KRISTEN: Um, something I remembered that we have to do is ask people to subscribe to the podcast!

[Intro music starts]

DANIEL: Hello and welcome to Speaking of Us, where language teaches us about who we are and where we come from. I’m your co-host, Daniel Bögre Udell, and I’m here with your other co-host, Kristen Tcherneshoff.

And before we get started today, I want to thank two of our Patrons, Genevieve Robitaille — Genevieve, if I mispronounced your name, please let me know on Bonjoro — and Will Goring. Thank you both very much for making the work that Wikitongues does, including this podcast, possible.

KRISTEN: And I am happy to introduce our guest we have today! We are accompanied by Dr. Abdesalam Soudi. Soudi is a professor of linguistics at The University of Pittsburgh. [intro music ends] He also works in the medical, humanities, and global studies departments. He’s a man of many talents; he has won tons of awards for being a fabulous teacher, including a few years ago an award for successfully creating a diverse and inclusive learning environment. His research focuses on conversation analysis, Arabic linguistics, and cross-cultural communication. We will be putting some of his articles and writings in the blog post that accompanies this episode. But for the latter one, we are excited to have you with us today Soudi, to take part in some cross-cultural communication ourselves!

SOUDI: Thank you very much, thank you both for having me, it’s a pleasure to be here with you. And thank you, by the way, for the introduction Kristen, also.

KRISTEN: It was fun to write it! [laughs]

DANIEL: Soudi, you have a multilingual background yourself. What are your languages?

SOUDI: Right. So, I grew up in the south of Morocco, southwest, southwestern area of Morocco. And — I grew up speaking Moroccan Arabic, known also as Darija. And, Standard Arabic, at some in which we start going to school, and informal exposure to Berber, and French, as well, in primary school. Around the same time I started learning Standard Arabic. And I picked English in high school.

So Darija, Moroccan Arabic, is what we speak. That is the first language we are exposed to, many of us. I mean there are others who are exposed to Berber as their first language. And so I grew up speaking Moroccan Arabic informally. I consider myself as a member of a diglossic community. Essentially what that means is two languages that co-exist, one is reserved for formal domains and the other is reserved for informal situations, and that would be Moroccan Arabic — with family, in casual conversations, outside with friends, that’s the primary meeting. So that is considered my first language, since I learned it growing up as a child, whereas Standard Arabic, or Modern Standard Arabic, MSA, is something that I started learning when I started entering school, through formal education.

And so it is, Moroccan Arabic is also the language of intimacy. Like I said, it is informal, it is casual, and it is a medium used for establishing solidarity. And so that is, you know, Moroccan Arabic is regarded as my first language, with some informal exposure to Berber. I don’t consider myself native, or native like a Berber, but I am a native speaker of Moroccan Arabic, Darija.

And like I said, I am also what is called a diglossic community member because Morocco is known to have this linguistic phenomenon known as diglossia, where there is a “high” [in this case] being the Standard Arabic, which is reserved for formal situations, and then the “low” [in this case] being Moroccan Arabic, or Darija, used for informal, casual settings with friends and family.

KRISTEN: Talking about diglossia, which you brought up and you explained for everyone, thank you. Arabic is a famous example around the world of diglossia and I was wondering if you could touch more on this phenomena around the world, what constitutes a language, because some call the Arabic varieties dialects or accents, whereas a lot of linguists classify them as different languages completely.

SOUDI: So, yeah, diglossia is a very interesting linguistic phenomena. The idea is so, two languages that are mutually intelligible, co-exist together, but they belong to separate domains. One which belongs to more formal domain, and which is known as the high, the “H”, there is that “H” value, high. And the other would belong, or would be used, as a medium of communication in informal, casual settings, with friends and family, so it would be the low, the “L” variety. So you have an L next to an H.

And it’s actually very interesting in the context of your framework, in the context of Wikitongues, about language loss and language sustainability and language preservation, is that diglossia actually helps languages maintain their status. It helps languages survive over time because precisely that they, the speakers, their status is protected because they are used in different domains. Moroccan Arabic usually belongs to the low domain, with friends and family, and Standard Arabic belongs to formal situations.

So you could, occasionally, use Standard Arabic in an informal setting and certain circumstances. For example, recognizing that someone from the outside is learning the language. But it’s generally very awkward to be using Standard Arabic, or the “H”, the high variety in a low context. It’s considered very awkward. It’s almost like somebody walking into a bar using Shakespearean English.

KRISTEN: [laughs]

SOUDI: That’s how awkward it can be. People will wonder what’s up with you. Like if I was to call my brother right now in Morocco, using MSA, Modern Standard Arabic, he would probably listen for a few seconds but then say, “is everything okay?” because that’s not something that is expected, that’s not part of the social norm for entertaining a conversation in a casual setting between family and friends.

I hope that captures a little bit. I am happy to expand, of course. It’s a very, very complex concept because people often confuse it with bilingualism. So diglossia, even if it has two varieties, it is not bilingualism. It’s not like speaking Arabic and French, that would be bilingual. So being diglossic is a speaker who has access to different varieties: one is high, in formal situations, and one is low. And it complements…one or the other, you cannot — you can’t find — I mean, you could find it, but there would be meaning attached to it. Of course no one is going to stop you from using Standard Arabic in a coffee shop, but there will be social consequences for doing that.

DANIEL: Would you consider this an apt analogy, historically in Southern Europe, for many centuries what constituted the Latin world, before what was called Vulgar Latin, kind of was standardized as the many Romance languages we know today, Portuguese, Spanish, Catalan, French, people tended — educated people, anyway — tended to speak Classical Latin, right like “high” Latin, Latin that was know as Latin today, as well as their dialect of Vulgar Latin. Obviously today that’s not very common in Europe anymore because few people actually learn what was, at the time, Standard Latin. Because although Vulgar dialects became standardized as the languages of formal register. But would you say that’s like an analogy, another historical example of this?

SOUDI: Definitely, definitely yes, that would be another form, another manifestation in another linguistic setting of diglossia. Along as there is a history of contact, an extended number of years between the two varieties, the standard and the low, the casual, the dialectal version if you can call it like that, and the formal standard Latin, that would be a very good characterization of diglossia in another setting. And so it is, yup, it is in a way, it’s also a certain segment of the population are not educated. But, even if every person in Morocco is educated, maybe twenty years from now, like I said at the beginning, Moroccan Arabic is not going to be, to disappear. Because it is protected by the domain, by the context.

KRISTEN: My question is actually the opposite, I was going to bring Latin as a diglossic example also because Vulgar Latin, as Daniel said, didn’t die as many often believe — it is still living, just in different forms today, in French and Spanish and other Romance languages. So my question for you, Soudi, was do you think the same could happen with Arabic, wherein we see Modern Standard Arabic, maybe in 100 years, not being used as much and these different varieties, Darija and Levantine Arabic, actually become heightened and are the main language in all situations?

SOUDI: It’s a very good question. It’s usually, always very hard to predict what’s going to happen to language.

KRISTEN: True.

SOUDI: And I think this is — this is why you are doing the work that you are doing at Wikitongues. It is important to find other ways to sustain and save those languages somehow.

Because, you know, so — there are some changes in Morocco. There is diglossia, but there is also a variety in between Moroccan Arabic and Standard Arabic called “educated Arabic” or in Morocco, we call it “middle Moroccan Arabic”. It’s sort of in between Moroccan Arabic and Standard Arabic. That’s the dialect, that’s the variety used by educated speakers. So, for example, I would like to entertain a conversation with another person about economy or politics, so we are at a coffee shop, so obviously it would be easier to entertain that conversation in Modern Standard Arabic because we have access to terminology to tackle the topic. But so again, we are in a coffee shop, so what we would resort to would be middle Moroccan Arabic. So we would borrow the lexicon from Standard Arabic, but we would be using the grammar of Moroccan Arabic. So, borrowing words to fill in for lexical gaps to sort of accommodate political or terminology pertaining to ergonomics that exist in Moroccan Arabic, but you will maintain the Moroccan Arabic grammar.

So, in a way, that’s a change, like I said earlier. So the need or the desire to tackle topics that Moroccan Arabic cannot — and again, I am not a fan of saying that a certain language cannot manage conversation about other things because every language system may be used, is capable of doing that. But because of lack of investment from the part of the speakers and the system, of course there will be lexical gaps in a particular dialect.

DANIEL: In terms of cultural investment in Darija, is there a movement to produce more media in the language, such as literature, television? I’ve noticed that uh, Egyptian Arabic has a lot of — I don’t know if it’s institutional, but certainly formal investment, for instance there actually is a translation of Wikipedia specifically into Egyptian Arabic, and as far as I can tell, it’s one of the only non-Standard Arabic languages to have that. So I’m wondering, is there a movement in Morocco to, um, elevate Darija, for lack of a better verb, I know that’s problematic for all the reasons we just talked about.

SOUDI: So there is a debate amongst policy makers, language policy and planning officials in Morocco. There has been a question for some time whether we should just teach in Moroccan Arabic and complete with it. Because it is a question of accessibility — would that have better learning outcomes amongst speakers? It was really — going back in my childhood, having conversations, casual conversations and debates, outside very comfortably. But then when I’m in a class in Standard Arabic, trying to discuss a topic, I would find it sometimes, find it very limiting. So there was a question about that, which could be a formal way of upgrading the status of Moroccan Arabic.

The movie industry has taken up, but compared to Egypt it’s much, much smaller. And that’s actually, movies is what makes the Egyptian dialect much more popular and much more famous and much more — also accessible to people and asks the question of some dialects, you sometimes hear speakers saying some dialects are closer to Standard Arabic versus others. Obviously it’s not a conversation from a linguistic perspective that you could be entertaining because every language is a — I mean, Moroccan Arabic is Arabic and Egyptian Arabic is Arabic. Often you hear Moroccan Arabic is not Arabic because it has borrowing, but every language has borrowing.

But I think we might be entering a different — sorry, I’m sort of shifting topics from, I’m departing a little bit from your question. So there is some, there is, but perhaps not enough to the same level you described with Egyptian dialects.

DANIEL: And so you live in Pittsburgh, Pennsylvania, not Morocco.

SOUDI: Yes.

DANIEL: And your wife is not from Morocco, correct?

SOUDI: No. Yeah, yeah.

DANIEL: So, what language are your daughters learning?

SOUDI: So my…yes, my wife is American, Irish background. So the predominate language used in our household is English. And we should be using of course Moroccan Arabic a little bit more, but there are — uh, you know, working towards that, we are making lots of efforts. We are sort of, we have a lot of plans in place, like […] in the language. But it’s very hard with the kids because most of their friends at school speak English, so they do have, naturally, more positive attitudes towards English than they do to Arabic.

My daughter, she is currently five and a half, my son is two and a half, almost three in July, so I think I see more opportunities catching up. Like during the last times with my daughter, I see some opportunities to start quickly with my son. But, my daughter occasionally she will express an interest. But like I said, because all of her friends speak English, she sees English as a vehicle to friendship and, um, integration into social circles in her school, and so that’s perhaps why she, she resists learning Moroccan Arabic. Which is very unfortunate.

My wife is learning, she’s also learning Arabic. We are currently celebrating the month of Ramadan, so we are, we dedicate some time in the evening after breaking the fast to say prayers in Arabic so that sort of — and…my daughter is sort of, welcoming this idea. For example, last night, she asked my wife if she could go upstairs and pray, so that was, that good! So this is some progress.

DANIEL: That’s wonderful. What do you think people can do to, uh, create a positive relationship with their language in their home? Because this is a challenge that people from cultures all over the world face, right? You know I speak a language that I want to pass on to my children and for whatever complex set of social reasons, my children are not as interested in keeping the language alive. Are there any universal lessons that can be utilized by people trying to keep their languages alive, when it pertains to creating a positive association with the language for the children?

SOUDI: It is, it is, so, there is definitely certain things. Definitely it is an investment. And especially in my household, it is unique. So for example, if my wife was from Morocco and we lived in the United States, it would be different, right? So this may not be the same thing to all, to all people who live outside of their country. So for example if my wife was from Morocco, it would’ve been easier. So I think it is a linguistic investment because one, she needs to learn first — if I entertain a conversation with my kids just in Moroccan Arabic, which perhaps I should have done, that would be considered for her as code switching, although she has been encouraging me, but it’s a bit awkward to have a multi-party conversation in the house, I would be the interaction manager, you know, saying things in Arabic, but then translating back to my wife what I just said and engaging her in the conversation. It’s very hard, you know? Sociolinguistically speaking it’s very hard, you know, it’s really an investment to, you know, it’s not very natural for me to, for me to just wake up in the morning and start to talking to everybody in Moroccan Arabic. Of course it is with the kids, right?

So, to go back to your question Daniel, it is very important to start early. I mean, we have a window of opportunity. We have until age 11 or 12 you know, that’s where the language acquisition device starts to expire with age, so we have an opportunity. So definitely start early. But also to keep in mind not just the number of years, but attitude. I think with my daughter, if we had start a little bit earlier and invested more — and l think it was like I said what was inhibiting is our family structure, the fact that my wife does not speak Moroccan Arabic.

So definitely start early. Connect with friends. I mean the other thing is that we live in suburbia, outside of Pittsburgh, so it’s very hard. Most of the families from Morocco that we know are at least half an hour away from where we live. So, connect with friends and family. Skype conversations in Morocco may be more regular. Skype, I mean for those who are able to access internet easily, have Skype, remote conversations with family members back home. And, maybe invest in books for children. Children’s books. Perhaps also movies. We started doing this, maybe once a week we watch a movie maybe in English, but the following week would be in Moroccan Arabic or another language. So that would be another things. Games would also be important as well. Something that kids would find fun and entertaining. And, and — especially friends because friends are an important part of their life. So if they realize that all their friends speak English, then they would worry about being socially isolated because, you know, you are using different codes.

KRISTEN: From a personal question, not talking about kids and language learning, what is one of your favorite films, movies, in Darija, from Morocco? I would love to watch some Moroccan movies!

SOUDI: Well these days I’m watching this sketch called […]. I’m really, I’m happy to share those with you. He’s a good sociologist too because it really captures real life in Morocco and people really identify with that, they relate to it, and hence, the comedy aspect of it. So that’s one of my favorite ones these days.

KRISTEN: Yeah, I would love to see it.

SOUDI: Happy to share, happy to share.

KRISTEN: Have you seen the new, um, Netflix show? It was, it was the first Netflix show called “Jinn”. It was done in Arabic, it was the first original Netflix show in Arabic, they just released it about a month ago, I would say?

SOUDI: No, I have not yet.

KRISTEN: Yeah, it’s been fun to watch. Um, but hopefully they’ll start doing so more and bring it to, you know, larger populations, going into different languages to record.

SOUDI: Yeah — but just, before you move to the next question — I want to make sure I didn’t come across as blaming my wife [laughs]. For the fact that my kids are -

KRISTEN: [laughs] No, no!

DANIEL: Oh no, not at all

SOUDI: But you know definitely, I just want to, it’s hard to think of a universal one. So I just wanted to capture the familial factors. There are families who are, with both, native speakers and perhaps it is much easier than mixed-marriages you know, for example. I mean, the idea of a mixed-marriage, it should increase linguistic diversity. But again, the friends aspect of languages really impact the kids’ attitudes. So if all of their friends or the majority of their friends speak a certain language, that’s where the kids are gonna go.

KRISTEN: Yeah it’s definitely one of those things that’s much easier said than done also. Especially with kids, we forget that, we also think of kid influence and pressures being really in your teenage years, but we forget that it starts way earlier than that. Of wanting to look cool around your friends, whatever that means at that age and it starts when you’re really young, in elementary school. And we forget that as adults. And so it is one of those things that is much harder to do and there’s things you want to put into practice, but it becomes difficult, um, yeah, my —

SOUDI: My — oh sorry, go ahead. You have a story.

KRISTEN: Yeah my, I was just going to say that my partner is not a native-English speaker. And I’m trying really hard to learn Finnish and speak with his family, although they speak English, but it’s one of those things that it becomes a lot of effort for him to constantly like speak slow and not speak in his dialect or in colloquial, spoken Finnish, which is very different from written Finnish, um, and it becomes such a challenge that it becomes just exhausting and at the end of the day everyone’s like ah, screw it, she’ll figure it out one day, like [laughs] we’ve given enough effort.

SOUDI: It is an investment because you don’t want your household to be a classroom, and that’s the thing. I have been -

KRISTEN: Mmhmm.

SOUDI: I want to avoid […] can you teach me, but you know, we have a different social framework, you are my wife [laughs], you’re not my student.

KRISTEN: Yeah.

SOUDI: And it is very hard then. And again, when you are at home, conversation is intended to be casual, authentic, and spontaneous. So, if it takes on that teaching mode, then it becomes like, you said, too much work and it requires a much bigger investment of effort and time.

KRISTEN: Mmhmm.

SOUDI: We’re mostly talking to the school as well. That’s another thing, you know, being engaged with the school. We signed up, my daughter, the school obviously did not have Arabic, but I said that any language would be great. And they said well we have Spanish. So then we signed up for Spanish, so she’s learning a little bit of Spanish.

KRISTEN: How is she liking it?

SOUDI: It’s good. Because she, again, she’s taking it with her same friends at school, who are also learning Spanish. So it was very, more motivational to do that. But I’m okay with that. Learning any language, at the end of the day, is going to be amazing for her.

KRISTEN: And your exchange program was in linguistics? Were you already interested in it at that time?

SOUDI: Yeah, yup. I have always been in linguistics. At that time I was actually doing something called clinical linguistics, I was working on language aphasia in Morocco. I started a project adapting the Boston Diglossic Aphasia Examination. It was one of the first assessments that was produced in the United States in the 1970s, so I started, and because we don’t really have any speech pathology protocol in Morocco. So actually my first linguistics project was to create a a test for working with aphasic patients in Morocco. So it was within that framework that I came.

KRISTEN: Could you explain a bit more. You said “clinical linguistics”?

SOUDI: Yeah, so my, I have — my focus was to take linguistics and apply it to speech pathology, language aphasia. This is essentially when people have CVA, cerebrovascular accident, they lose their ability to use language and then they go into language rehab. So, this is in Morocco, is very — does not exist. We don’t really have any language rehab tests.

So what I did, at the time, was adapt one from the United States known as the BDEA, the Boston Diglossic Aphasia Examination, that we were able to translate, but also adapt to the Moroccan culture as well.

Does that explain? So language -

KRISTEN: Yes.

SOUDI: It’s also explained as language loss. Not language loss in the Wikitongues framework, but more of language repairment.

DANIEL: So this is, in essence, when you have some sort of, when you suffer some sort of physical or neurological damage that prevents you from accessing your languages, you have essentially lost your languages and there are clinical treatments to recover them.

SOUDI: Right. And in Arabic there aren’t many. Like at this time, actually I had a linguistic supervisor that I was working with that I mentioned earlier, and I also had, I recruited someone from the school of medicine who was a neurologist, that was working with us on our team, to adapt this test and create one for Moroccan, well, at this time we were — it really goes back to the question that we also needed one for Moroccan Arabic as well. Because the idea is that if you do end up designing one for Modern Standard Arabic, the patient should have spoken said Arabic for having the stroke or for having the ability to speak the language so looking back we probably also needed something in Moroccan Arabic and Berber as well.

DANIEL: One language at a time-

SOUDI: Yes, yes, one language at a time.

DANIEL: So, we need to take a short break, but when we come back we’re going to learn a lot more about Soudi’s work in clinical linguistics at the University of Pittsburgh.

[intro music plays]

DANIEL: Hello and welcome back to Speaking of Us where we explore language teaches us who we are and where we come from.

In our last episode, we had a question from one of our patrons, Chris Webber, who asked us about the role that language plays in your worldview and of course what this means for adult learners who wanted to know if we were predetermined to remain trapped in the worldview of our mother languages or if we could open our understanding as we learn languages as adults. And we helped explain that of course your mind is always available to be open and that it is never too late to learn new things about yourself and about the world from learning new languages. But there was one part of the question that was very neurolinguistic and given Soudi’s background, we would love your take on it Soudi. So, he asked, “if I’m not mistaken, if a language is learned later in life after the quote on quote critical period, then it is stored or centered in a different part of the brain than our native languages”.

Is that true? How does your brain neurologically process languages that you learn as a child and then later in life?

SOUDI: Well, first of all, that’s really an excellent question and a very difficult one also, it brings up a lot, and connects the brain, society, culture, world perspective all at once. So definitely there is value to obviously learning new languages, definitely the language we grow up speaking shapes our perspective. We view the world through the lens of the language we grow up speaking, um, and obviously when we learn a language then our perspective is expanded and becomes more diverse, so there is obviously always value to learning more than one language. There is also, part of the question also, it is true there is linguistic and neurolinguistics evidence to the earlier you learn the language there is something called critical period hypothesis, introduced by Lenneberg years ago that learning after age 11 becomes a little bit difficult as far as pronunciation is concerned. And so for example I have an ESL accent, I mean everybody has an accent, right, but I do have in reality an ESL, English as a Second Language accent, precisely because I learned English at much later in my life.

So, for example if I had learned English at the age of 5 or 6 perhaps, then I wouldn’t have what is called an ESL accent. There has been some work where are those in turn, because Chomsky and others have talked about linguistic endowment, something that people are, when every child is born part of their brain is that language acquisition part that allows you to learn any language that you are exposed to as long as you do that as a child. So there has been some work to see if those things can also be active or reactivated in the process of learning a second language. And so that’s a little bit outside of my work, the second language acquisition research, but to the extent that you learn language before age 11 it is easier. And if you learn it after age 11 it gets a little more difficult.

The idea of bringing back the topic we were talking about earlier again, such as on this question again is language loss. There has been some work where there is someone who’s a speaker of three languages, or two languages, and they have a CVA, a brain legion, which language would be more resistant to damage? So, if someone learns Arabic as their first language and then they learn French and then later in their in their life they have a stroke, there isn’t really reliable research to show which one.

There are some theories that the one you learn first will be much more resistant to damage, but some other people will say well it really depends. But it goes back to your question Daniel which is again a little bit slightly outside of my work, where is the second language localized in your brain, exactly? Are they all stored in the same area or not? But it also really depends on, I do believe that part of your brain allows for languages to be the same, whether one is resistant to damage or not that really depends on, I believe, frequency and complexity of the language, exposure and availability.

So, for example if somebody speaks Arabic and English there is obviously a lot of language assessment testing in English then it would perhaps make sense to do quickly because the sooner the better to quickly do language rehab in English. Also the environment too of that person because part of the rehab is not just having one hour a week or one hour a day with a speech pathologist or a speech rehab person, also the environment. So if in the family environment they are using English, then that could perhaps be the language that could be chosen or selected as the language of treatment.

So, again, this is a very multifaceted, a very important question and I hope I was able to provide some answers to this question.

DANIEL: Do you think this could change over time? So for instance, I speak Spanish, but lately I don’t speak it on a daily basis, so if, when I was living in Zaragoza and Spanish was my language of daily communication, would Spanish have been more likely to be retained if I were, to have suffered a neurological accident than now, given that I don’t use the language everyday?

SOUDI: Perhaps, again I don’t think I can answer your question scientifically. I will be just circulating. Yeah.

But, it really also depends on the morphology and phonology of the language. For example, there was a study that looked at, compared French and English patients. The study found that the French patients did not lose the definite article, whereas English aphasic patients lost the definite article. And so, one of the explanations was that the French article is such a salient, has much more of a load, a linguistic load semantically and morphologically because it is marked for gender and number, right, le, la, les. Whereas English is not marked, it’s just the boy, the girl, the, you know — so perhaps again that might have made a difference because something is more salient and even after a stroke perhaps people would retain it. But again, that’s one study, so perhaps I think we need to look at it more to really know for sure that that’s the case that things that are much more linguistically salient would perhaps be retained than others.

KRISTEN: So, a few years back you launched the Humanities in Health conference at the University of Pittsburgh. I think it was the first one to be held, inaugural of its type, and this conference looked at the intersections between linguistics, family medicine, gynecology, and so, could you tell us a little bit more about what inspired that and what we can learn from these convergences. And as a woman, I am in particularly interested in how gynecology plays a role in linguistics.

SOUD: Right, yeah, thank you, that’s a very, very good question, thank you. So, the work actually with HinH, Humanities in Health is we launched the first ever conference, that’s really, very deeply on the topic. But before that the conversation had started way before that. My — Humanities in Health started, with the example we just gave, in Morocco applying linguistics to aphasia or language loss, following the brain damage. And then after that when I came to Pittsburgh, I met the chair of family medicine Dr. Jane _____ who just retired recently this past Decmeber. She was teaching cultural competency at Children’s Hospital, so then she invited me to co-direct, this was a master level’s course called Social Competency in Medical Education, that physicians and fellows and residents take if they are pursuing a masters in public health or other forms of graduate education. So that’s actually the beginning of it. That’s the beginning of Humanities in Health.

Before that, before the 2016 conference, I did my PhD on the impact of technology when doctors are using the computer and talking to patients. So where I bridged again humanities and medicine together. And through a partnership I have established between my department of linguistics and family medicine and a primary care center within UPMC, the University of Pittsburgh Medical Center.

So, yes we, the partnership started as family medicine, linguistics partnership through a cultural competency course that was co-directed with […] and the year 2015, the provost had announced the Year of Humanities and what could be better than Humanities in Health? And at the time, I was trying to also grow the linguistics program and find applications in other areas, so I took advantage of that opportunity and we applied for a grant from the provost office. We would be successful in securing the grant from the provost and we were also successful in securing support from UPMC Hospital and other organizations like Magee Women’s Hospital, as well in family medicine. And so it became, our initiative became a cross unit initiative, that also invited Department of Obstetrics, OBGYN Dr. Judy Chang who works also with using humanities in her work.

One area they have been a part of with Dr. Judy Chang was IPV, intimate partner violence discourse. So, of course, using linguistics to find ways to help patients disclose if there is any abuse, but also using linguistics to detect if there is abuse in a partnership. So, Kristen, I hope that answers your question, your appeal to how OBGYN is involved. So that’s one part. Dr. Judy Chang and I met through a student of mine and then we started this collaborative work that started HinH, Humanities in Health. After that, we also invited again the school of business, the school of education, and also recently the school of computing information through, in another project called the Humanities at Work. That again, I founded in 2017 following a state grant from the chancellor’s office.

So, just to recap, the Humanities in Health initiative is a cross-unit partnership. It started initially as a collaboration between myself and the Chair of Family Medicine through a course called Social Competency that we were both directing. The audience has always been physicians, fellows, and residents. We actually just completed another one just last Friday, it was our last session. And then it extended, the partnership extended to include other units like the OBGYN, School of Business, School of Computing, and School of Education, as well. But also builds on my work, my PhD dissertation that looks at the impact of technology, electronic help faculty, when doctors are using computers to interview patients. Meaning, they are interviewing the patients, but at the same time entering data on the computer about the patients, which presents obviously multiple involvements through multitasking.

KRISTEN: That was a question I was hoping to get you to talk a bit more about between these intersections. What is the role of, where do we find sociolinguistics that affects the patient or the doctor in these intersections?

SOUDI: Yeah, well, as you know, sociolinguistics can be found everywhere, you know, because it has applications to everything. And, I am not, I’m obviously a little bit biased because I’m obviously a sociolinguist, but it is part of everything. We use language in society to socialize. I mean, as I always say, in reality, we are all, every one of us, is a sociolinguist because we grow up using language in society, because we grow up using language through social lives, in interactive social settings. We grow up using language to negotiate meaning, to negotiate identity, to do a lot of work, to do a lot of things with language. So, we all have that entitlement to be sociolinguists.

This is however, for those of us who have actually gone through education to be sociolinguists, we can be very systematic about these things. We can understand, posit qualitatively, and also in a quantitative way. And we can actually put language under a microscope and find how it actually works in society to recover meanings and understand how people connect with each other. With regards to sociolinguistics, it is very practical to the field of humanities and health, taking the examples of using for example a computer, or even another example of how doctors close conversations with patients. In my previous work I looked at the conversation closings.

How do you close your conversations Kristen, if I may ask you, if you don’t mind me redirecting the question to you?

KRISTEN: How do I close conversations in-

SOUDI: In general.

KRISTEN: In which regard? In general? I… see you soon, hug, goodbye.

SOUDI: See you soon. What about you Daniel?

DANIEL: Um, I suppose it depends on the conversation. See you soon, hug, goodbye is definitely a favorite of mine, um, but, if it’s a conversation where both of us is expecting an outcome, like in a work call, I’ll summarize what each of us has to do next. Sometimes I thank people for their time, if it’s a conversation that I kind of asked for, um, and I don’t know the person very well, I guess it really depends on the level of intimacy I have with the person and the personal relationship, and the point of the conversation.

KRISTEN: I was just going to add if it’s a conversation with a friend of mine that speaks another language that is not English, and it’s a language I’ve been learning, I’ll often try to say goodbye or at least give my greetings or salutations in their language if I’ve been learning the language.

SOUDI: Right, but we all agree that closings, the closing phase of a conversation is very important, you know? So, it’s the same thing, we use this information as well in a doctors visit. We want doctors to close very well with patients because bad closings will send bad messages to the patients. And it’s very important because that’s when we make arrangements for the next visit or a summary the visit, to make sure the patient doesn’t have any other questions, we provide them the opportunity.

So, we don’t want people to close abruptly, we want people to give others the opportunity to say something or is there something else you want to add or talk about. People for example have written about doorknob concerns. A doorknob concern is those last minute concerns, which is when the physicians hand is on the doorknob, ready to leave the exam room, and the patient says “by the way”, bringing in a new topic that’s very important. “By the way, I’ve been meaning to talk to you about my cholesterol…” or something very important that would then require the physician again to open a whole new conversation.

But conversations are also important for establishing, for improving relationships, and improving connections with people. Again you both said “see you later.” You both like issuing what we call an “arrangement sequence”. And those are important because if you don’t say “see you later” you risk implying to the other person that the relationship is done, right? And that’s one of the negative implications of proceeding to close any conversation in any language is there is that implication that the company of the other person is not desirable or it’s boring, so you sometimes will say “I really enjoyed meeting to you or talking to you. See you soon”, meaning it’s not the end of the relationship, just the end of our current conversation. And we find that information is used in business meetings, in a doctor-patient relationship as well. So, in other words, I think raising awareness to professionals about the linguistic choices they use on a daily basis with their patients, with their friends, with their students, is very important for engagement.

So, we have in other words, the reason why I asked how do you close, we all have access to this conversational machinery, but none of us think about it consciously to say “well today, I am going to close the conversation with Kristen using a blame strategy, so I’m going to blame her for closing. “I know you have a lot of things to do Kristen so I’m going to let you go”, so I’m blaming you for the closing. Or, let me use arrangement sequence: I’m going to say, “See you later, see you next week”. But those are important for us to think consciously about these things and other ways we use language.

DANIEL: So, in other words, it is essential for medical practitioners to be consciously aware of how they deploy language in their interactions with patients because that can have a really profound impact on how the patient perceives their care and you know, by extension, how they will positively or negatively engage with their care.

SOUDI: That’s right. And it is also, it is very important to be thinking about that exchange. Giving another example that comes from a linguist who did some work with patients. So, a patient comes in to see a physician and during the interview the physician asks the patient, “How long have you been smoking?” So, the physician was expecting a number, four years, five years, seven years. The patients answer was, “Since I got married.” So, that essentially sends the message [laughs].

And that shows, I mean that example really shows, that is a prime example of doctor-patient…doctors and patients are not on the same agenda. Patients are usually on a social agenda, and physicians are sometimes on a biomedical agenda. I think you need to bridge both because yes, the number of years is important, but it is also important to allow the patient to talk about their marriage. So, the physician has to make a decision; should I just smile and ask the question again or should I open a conversation and talk about the patient’s marriage? Which is important? Apparently his marriage is more important because he’s blaming marriage for his smoking behavior.

DANIEL: I was going to say that I had a doctor once who very expertly deploy language in a conversation with me. It was a check-up with a new doctor and she asked me how much I drink and I told her and she said “oh, do you think that’s too much?” [laughs]. And I was like ….uh??

SOUDI: Well, there you are.

I mean, again, so how did you find that? Much more threatening or much less threatening?

DANIEL: Oh, much less threatening because it allowed me to evaluate myself. If a doctor tells you that you drink too much that just makes you feel bad.

SOUDI: Exactly, exactly. And it also helps reduce that I am a medical doctor, I have more power than you. It helps engage others in decision making as well like you said. It gives you stuff to evaluate yourself. But the bottom line is disease is more social than physical, at least in my opinion. I think the social aspects of disease are very important. For example, a grandmother or grandfather at home lives upstairs and have knee problems are physically unable to come downstairs to socialize with their grandchildren, that’s actually worse. So the social parts of their knee problem is — its impact is actually worse than the physical impact, I think, in my opinion.

DANIEL: So, what about pandemics? How can we take this principle and apply it to flattening the curve of rapidly spreading and uncontrolled diseases — or viruses like COVID-19 for instance?

SOUDI: Well, the problem we are facing with COVID-19, well obviously it is a very hard disease to understand clinically speaking, but I think what it is showing us is that — I think there are some decisions we are making that are not culturally and linguistically sensitive. And I think it goes back…so the disease itself magnifies a lot health and economic disparities that already exist in our society, with respect, for example, to language. I think people, for example, with limited English proficiency population in the United States, for example, are the last people to get the information. Like, lots of broadcasts are done in English, so you know they do not understand right away, it takes a few days for materials to be available, so they are lagging behind. So I think — I mean, there are efforts, linguistic accommodation efforts, to make this information accessible.

Also, this confusion around it, again going back to the topic of language, I think people who know English very well, I think I find it sometimes confusing when people use terms like “shelter in place” or “shelter at home” or “safer at home” or “lock down” or “quarantine.” I mean, those things have meanings, they have technical meanings, “quarantine” it has a clinical meaning. It is somebody who has been, for example, who has been exposed to somebody who has the virus and they need to quarantine — isolate is if somebody actually has the virus. Shelter in place is really for me, when I learned this word, it was in association with tornadoes, not in association with the virus. And the same thing for lockdown, you know, it’s something that you hear in an active shooting training or something, lockdown.

I think, and this obviously poses problems for people who have don’t speak English very well, but is also tied to literacy. People who don’t have English proficiency population will suffer more. There will be a lot of opportunities for miscommunication, right, what does it really mean shelter at home? Well, if you really break it down to people, you know, it’s essential go outside only when essential, or something like that, and really have to break it down in that language.

And also vary by the culture too, what does going outside might mean for people might vary as well. So I think there is some diversity and cultural competency issues obviously, really the main framework is what we call in the course we are teaching, is what we call Social Determinants of Health. Is something we also need to keep in mind that Social Determinants of Health-

DANIEL: Social Determinants of Health?

SOUDI: Right. So, introduced by the World Health Organization, between 2005–2008, and obviously, it has always been there since the 70s. There have always been initiatives that focus on the social aspects of medicine, but Social Determinants of Health have really a special meaning, and it specifically means the environment where we work, where we are born, work, grow, age, go to school, and so on and so forth. So, it has to do with the physical environment, with our socioeconomics, with our income, with our education, and under that literacy and language. And those Social Determinants of Health believe it or not actually accounts for, that in addition to behavioral, environmental, they account for 80% of our health, 80% of our health.

Twenty percent is, has to do with access to healthcare and services. But 80% environmental, socioeconomics, housing, jobs, and so on and so forth. So, when you are saying things like “social distancing”, well…easier said than done. So, I been — social distancing for somebody like myself, who can work from home, it’s a privilege to observe social distancing and abide by it. It is really a privilege. So, people are being thankful and people are enjoying it. They are able to work from home and they have everything they need. But some people are really having a hard time doing that because they live in a crowded neighborhood to begin with. I mean I have a driveway outside, I live in a circle. I have a backyard where the kids can go, so I think we need to be thinking about those things too. We also need to think about, in the context of housing inequity, but also in terms of socioeconomics and poverty. Some of us go shopping once, you know one of the rules is shelter in place, but some people need to go more than once because they can only afford to buy certain things at a time.

Some of us are able to go to the market once and buy everything they need for a month and then that’s it. So I think we need to, I think again that diversity becomes really an issue and social isolation is also becoming a problem as well where not everybody has technology to Zoom with friends and Skype with others. So, so I think we do need to keep these things in mind as well.

DANIEL: And also that not everybody, that the same recommendations don’t apply to everyone, right? Like if you’re a rural Amazonian community where you know the virus hasn’t arrived, what you need is not necessarily is to practice internal social distancing but to prevent the arrival of outsiders, right? So like if you have to close your village ports and don’t let any river boats in. Like, that actually is you know, more important than social distancing between yourselves, in that kind of context. That’s like an added layer to this that’s also really important.

SOUDI: And unfortunately, with social distancing there’s other problems that are unnatural. I mean we will accept something that is natural as a disease, but something as unnatural as the environment where we live and where we work and where we were born, our socioeconomics when it’s starts shaping our health that’s unfair. You know, a disease that is natural is ok, but something that is unnatural is unfair because it is primarily due to lack of initiative which is due on some of the part of the government for equity, housing equity, and better economics. And yes, going back to your point, I think when we make decisions we need to be culturally competent and more inclusive, keeping in mind that the diversity of the people that we are serving. That’s very, very important.

And also, I think another point that came to my mind and in this context as well is linguistic discrimination as well. I think the language used to reference the disease of the virus itself shouldn’t be linked to ethnicities and races. It should be just the medical term and I think that’s the other thing that we need to keep in mind. Because that sort of leads to discrimination and hate crimes as well.

But so, this is again, this is important especially for language again, the limited English proficiency aspect of it. I think that the population is lagging behind. They are not up to date and sometimes worse they are getting information from overseas, from back home. I’ve been part, for example, of WhatsApp groups, where you know we hear the different context. They have different rules over there, you know it’s a different system. So I think there should be better efforts to accommodate speakers of other languages during a pandemic.

DANIEL: Because, as we’ve been discussing, a more intentional use of language in medicine would not only save lives, but make the overall experience of healthcare better for people around the world.

SOUDI: That’s right, that’s right.

DANIEL: So, um, we gotta close this book. But I would love to hear any final thoughts, if there are final thoughts. If there are things that you think we missed, Soudi, over the course of this conversation that bear mentioning.

SOUDI: First of all, I really, once again, I appreciate this opportunity to engage with you and learn more about each other using language again to explore and learn more. There is always an invisible aspect of our personalities that we can only find by having conversations and allowing each other to share. I’m referencing the iceberg model: there is always that part that’s hidden, so I really appreciate this opportunity for us to get to know each other more. Even through this conversation I appreciate more also what Wikitongues does. I think we talked about a variety of topics, where I could see the practical applications of your work, whether its language rehab, having access to materials online, digitized. Times like this, having information available in other languages is I think there is a lot of value to the work you are doing as well at Wikitongues.

DANIEL: Well, thank you.

KRISTEN: Thank you so much for joining us and thank you for your kind words. And shukran bizef.

SOUDI: Shukran alaykum.

DANIEL: This has been Soudi Abdesalam from the University of Pittsburgh. If you want to follow more of Soudi’s work, you can follow him on Twitter @profSoudi. He also has a new website: pitt.edu/~soudia.

This has been Speaking of Us where we explore what language teaches us about who we are and where we come from. If you want to support us on Patreon, you can find us at patreon.com/wikitongues. All supporting materials for this podcast can be found at wikitongues.org/podcasts. Shukran, or in other words, thank you.

[Closing music plays].

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