The gift in A&E: re-framing the medical case presentation through Mauss

Abstract

Case presentations have totemic significance in medical sociology, in which they are analysed as emblematic of medical professional culture. This article makes a case for conceptualising these exchanges in terms of Mauss’ account of gift-giving, which theorises sociality in terms of obligations voluntarily incurred and reciprocated and the performative recognition of hierarchy. This contrasts with two alternatives in existing literature: the case presentation as an instance of pedagogically oriented supervision and legitimate peripheral participation; and as representative of professional discourse more generally. We make our case for re-framing the case presentation in relation to video and audio data generated within a study of an Accident and Emergency department in the UK. We conclude that Mauss’ concept of community allows us to see discursive phenomena that have been overlooked, and to theorise the work of junior doctors in terms of collegiality in a hierarchically organised profession, by contrast to a defective version of the work of their superiors or the manifestation of singular professional discourse.