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MohammadSamy
ProfessorPavelZemliansky
ENC1102H
April18th,2016
Revisionexplanation:
Themajorityofmychangesweremadeinregardstothecommentsthatyouhadlefton
mypaperpreviously.Ihavealteredsomeofthebeginningofmypaperinordertoexplainthe
sourcesthatIhaveused,sincepreviouslyIhadwrittenundertheassumptionthattheaudience
hadpriorknowledgeofmycitedsources.Ialsoincludedasectiontowardstheendinaneffortto
explaintheimportanceoftheconnectionbetweengenre,rhetoricalsituation,anddiscourse
communities,whichwouldworktostrengthentheimportanceofmyanalysis.Throughoutthe
paperIalsomadesmallchangesinordertoclarifytheconceptsindividually.Lastly,minor
changesweremadeinordertocorrectlyaddresstheworkscitedaswellasanydifferentsources.
TheReachofGenreonthePresentandFuture
Inthispaper,Iwillbeanalyzingamedicalcasereportfrommymajorofbiomedical
sciences,specificallyinordertoanalyzethekeyqualitiesitportraysofthemedicalcasereport
genre.TherearemanydifferentpartsrhetoricalarticlesthatIwillusetoestablishthatthereisa
verymuchpersonalaspectthatisprevalentinthewritingofthemedicalfield,andthatthereis
notonlynumbersandlonglatinnames.ThispointinparticularwillmakeusemostlyofMatthew
Allenspaperwhichdiscussestheideathatscienceisseenmainlyasobjectiveandstrictly
dataoriented.However,Allenarguesthatthereisarhetoricalaspectthatworksalongside
sciencesobjectivity,andthatitisnotallunbiased.IwillalsousetheconceptsthatGrantDavie

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presentedinhisarticleregardingexigence,audience,andtheconstraintsthatareplacedupon
bothrhetorandaudience.Intheirpaper,GrantDaviewritesabouthowexigenceistheneedto
respondtoasituation,andthattheaudiencecanincludethegroupofpeoplewhoareintendedto
viewawork,aswellasthosewhomaynothavebeentakenintoaccount.Theconstraintsarealso
anythathavebeenplacedonthesituationthatcanconstraindecisionandaction
(272,GrantDavie).ThesewillframemyanalysisasIwillbeusingthetermssimilartohow
GrantDaviedefinesthem,howevertheywillbealteredtomoreeffectivelyworkintandemwith
thegenreofmedicalcasereports.AsIwillgoonlater,theaudienceisalargedeterminingfactor
ofthemedicalworld,andrequiresadifferentapproachthantheoneseeninthearticle.Thefocus
anddriveofmyanalysisistoexplainandshowclearlyhowthegenreofmedicalcasereports
workswithinthecommunitythroughalterationsandadvances.Todoso,thequestionofhow
casereportsinteractwitheachother,aswellashowtheultimategoalsachievedmustbetaken
intoconsideration.Inordertoaccomplishthis,therhetoricalcomponentsmustfirstbeclearly
defined.
Therearemanydifferentaspectsofrhetoricalsituationthatwehavestudiedsofar,of
whichIwillfocusonakeyfew.Innoparticularorder,thefirstoftheseisquiteobviouslygenre.
Ihavechosenaspecificformofmedicalwriting:medicalcasereports.Ascanbeseenfrom
MaryJoReiff(2003)whoutilizesCharlesBazerman,genreismoreakintoroadmapsthat
studentwritersconsultastheynavigatethesymboliclandscape(553).Despitemanymedical
casereportsfollowinganagreeduponform,therearestillenoughvariationspresenttoarguethat
notallreportsaredevoidofrhetoricalthought.Thestructurethatcanbeseenamongthecase
reportshascomemainlyfromthenecessityofrelayinginformationefficiently.Fromthearticles

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thereweremanyaspectsthatweredescribedofwhatiscommonlyseenamonggenreand
discoursecommunities.Mostoftheauthorsreferenced,suchasSwalesandGrantDavie,
describethatthemechanismswithwhichacommunityinteractswithitself,aswellasthe
languagethatisusedwithinthecommunityoftenplayapartindefiningthecommunityagainst
othersandkeepingonegroupfromblendingintoanother.
Manymedicalcasereportshavebeencreatedoverthetimethatscienceandmedicine
haveadvanced.Thevocabularyhaschangedtobecomemoreefficientandspecific,aswellas
evolvedtoencompassnewdiscoveries.Pastcasereportsarecontinuouslybeingstudied,andthe
neweronesthatarebeingmadetodaybuilduponwhatisseenasthecurrentgoal.Thisisakey
themeseenindiscoursecommunities,whereovertimeacommunitywilldevelopacertainlexis
thatisprimarilyusedandunderstoodbythemembersofthecommunity(Swales26).This
providesevidenceofarhetoricalanddiscoursecommunitybecausethelanguageshowsefficient
communicationaswellassharedexperienceamongmembers.Anotherthemedeemednecessary
isexigence.Forarhetoricalsituationorgenretoform,theirmustbeaneedthatsomeonecan
respondto.Thispurposeofamedicalcasereporthelpstoexplainwhatislargelyincommon
amongthegenre,aswellastheoutcomethatistypicallydesiredwithinthecommunity.
Regardingthecommunity,anotherkeyconceptthatwillplayaroleisbetheaudience.The
audienceofcasereportsisheavilytakenintoaccount,aseverythingmustbedocumentedclearly
andconcisely.Swaleswritesinregardstodiscoursecommunitiesandtheirmembers,thatthere
isalimittotheamountthatcanbeapartofthecommunity(27).Allotherswhowouldbe
outsidearereactinginsomewaytotheactionsofthecommunity,whichiswhythereissuchan
importanceplacedonhowthecommunityisperceived.Itisexpectedthatwhomsoevermayread

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thisshouldbeabletoclearlyknowexactlywhatthesituationwasandwhatapproacheswere
consideredandultimatelychosen,aswellasthereasoningbehindallthis.Thisisbecausethe
intendedaudienceforacasereportincludesthoseinthefuturewhowilllookbackinaneffortto
furtherthequestforknowledge.Thesepeoplearealsoexpectedtounderstandthemedical
terminologyused,asitisnecessaryforthemtobeabletoclearlyunderstandthesituation.The
audiencemaynothavetheluxuryofbeingabletospeakwiththereporters,howevertheywillbe
abletousewhathasbeenwritteninordertoformconclusions.Specifically,aroundthe1960s
and1970s,thereweremultiplecasereportsthatwerebeingwrittenthatdescribedpeculiar
infectionsaswellasabnormaltissuegrowth.Atthetime,thosethatwerewritingthecasereports
didnotknowwhatexactlytheywerewitnessing,howevertheyknewtowriteitdownwithas
muchdetailastheycould,aswellastheirthoughtsonwhatitcouldbe.Thiswouldeventually
leadtothediscoveryof:acquiredimmunedeficiencysyndrome(AIDS).Criticalfindingsare
alsodiscoveredbyreflectinguponpastcasereportsandbeginningtoseetheconnectionsthat
certainitemsoractivitiescanhavewithoneanother.Inparticular,itwasthroughcasereports
thatdoctorswereabletolinkthecauseofmalformationsinbabiestothedrugthalidomide,
whichhaduntilthenseenadecentamountofuse.
Tounderstandhowmedicalcasereportsworkandevolve,itmustalsobeexplainedthe
ultimategoalsofthemedicalcasereportsaswellasthemethodinwhichinteractiontakesplace.
ThegoalsofamedicalcasereportareoneoftheexamplesgivenbySwalesin
TheConceptof
Discourse,
whichexplainsthat

Adiscoursecommunityhasabroadlyagreedsetofcommon
publicgoals.

(Pg.24).Thesegoalsareseenbythoseevenoutsideofthecommunity,andare
ultimatelywhatthegeneralpopulaceperceivesastheintention.Forthepurposeofthispapers

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analysis,Iwillbeusingtheperceptionthatthemedicalcommunityspublicgoalistohelpand
healpeople.Withthisinmind,itisclearthatthecriteriaforadiscoursecommunityaremet,
includingothersstatedinthesamearticle,suchas

adiscoursecommunityhasacquiredsome
specificlexis

(26)aswellas

Adiscoursecommunityhasmechanismsofintercommunication
amongitsmembers

(25).Forthelatterspecifically,medicalcasereportsareagenrewherein
membersofadiscoursecommunityareabletoparticipateandhaveanimpactwithinthe
community.
Multiplemedicalcasereportsarewritteneveryday,andthesearealleitherarchivedfor
laterstudy,ortheycanbesenttomedicalcommitteeswithinthecommunityforfurtheranalysis.
Inthisstage,membersofthecommunityareabletoinputonfindingsandpriorresearch.The
memberswhosubmitthereportmaynevermeettheoneswhocritiqueit,howeverasstatedin
Swalesarticlealthough[they]mayneverinteract,theyallhavelinesofcommunicationbackto
base(25).Inthiscase,thebasewouldbeconsideredthecommunity,andthecasereports
functiontoofferalternateviewstoaideintheprocessofmedicalstudy.Thesealternateviews
aregainedfromtheresearchofpriorknowledgebynewminds.Thisisindicativeofthequality
ofthemedicalcasereportgenre,whereinpastreportsarestudiedandusedtoaltercurrent
theoriesandfurtherunderstandingofthemedicalfield.Thisisoneofthemainfunctionsthat
workstodefinethepurposeandexemplifiestheworkingsofthemedicalcasereportgenre.The
abilitytobuilduponthepastishowhumanityhasgrownandadvanced,andthisisnotjusta
formthatisfollowed.Thiscanbeseeninmanyrhetoricalsituations,aswellasgenresincluding
thatofmedicalcasereports.

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Havingdefinedextensivelythestatusofmedicalcasereportsbeingagenre,aspecific
reportIhavefounddisplaysmanyoftheexamplesgiven,andshowshowthegenrefunctions.In
thismedicalcasereportwrittenbyHammad,Ahmed,etal.,theformfollowsmuchofwhatis
commonlyseenincasereports.Itbeginswithanabstractthatgivesanoverviewoftheentire
case,includingconclusions,inonlyafewparagraphs.Thisistoeffectivelypresentthe
informationsothatanyofthefutureresearchersviewingthiswillunderstandquicklywhatthe
reportwasabout,withoutwastinganycrucialtime.Thereportthengoesontodescribeindetail
thebackgroundofthepatientandthecurrentsituation.Definitionsarealsosettoclearanyfuture
confusions.Forexample,chroniccanmeananythingthatpersistsforalongtime,howeverthe
reportersstatethatChronicosteomyelitisisdefinedaslongstandinginfectionthatevolvesover
monthsorevenyears.Thereportthengoesontopresentthemaincase,andthisiswhere
evidenceisfoundthatthereisamorethanjustformtothisgenre.Althoughthereporters
underwentthevarioustests,itisevidentthattheyhaveanalternateviewofthisparticularcase.
However,hepresentedtoouroutpatientclinic2monthspostoperativelycomplainingofpainin
hisleftkneefollowingadirectfallonhiskneethatoccurred1weekpreviously.Onphysical
examinationtherewasnoredness,warmthoranobviousswellingofhisleftknee.Nojoint
effusionwasfelt.Nolocaltendernesscouldbeelicited.Theynotedthatitwaspeculiarforthe
patienttohavecomeback,whentheyhadexpectedtohaveseenhimuntilnotamonthlater.This
reportalsoendswiththeconclusionthatwhilstthiswasanuncommonform,theydostillbelieve
thestandardtreatmenttoberecommended.Thiscanbelinkedtothefunctionofthegenre,where
theaudiencethatisviewingthisreportinthefuturecanthinktofirstlyfollowthedescribed
standardprocedure,andalsotoundergotheprocedureseeninthereportifneedbe.Lastly,the

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audienceoutsideofthemedicalcommunityarestillheldinhighregards,astheyarenotonly
listedashavinggivenconsent,buttheyarealsoacknowledgedforallowingthereporterstouse
thedatainordertopublishamedicalcasereportthatcouldverywellsaveafuturelife.This
showsasoneofthemanymedicalcasereports,thatthepurposeandaudiencearelargely
prevalent,workingtodefinethegenreashavingpartbothinrhetoricalformaswellasfunction.
Fromtheexampleitiscleartoseethatmedicalcasereportscontainqualities
characteristicofagenre,howeveritisimportanttonotetheconnectionthatisbetweenagenre,
rhetoricalsituation,andadiscoursecommunity.Althougheachofthemareimportantintheir
ownright,everycomponentisnecessaryinordertofunctionproperly.Therhetoricalsituationis
keyincreatinganopportunityforagenretoform.Itistheresponsetoasituationinwhichan
individualfeelstheneedtoreactthatallowsforthebeginningofagenre,andeventhisreaction
cancreatepossiblefurtherrhetoricalsituationsinthefuture.Thediscoursecommunityisalsoa
connectedfactorbecausealthoughitsmainpropertiespertaintomechanismsofinteracting
withinthecommunity,therearediscoursalexpectations(Swales,26)thatdevelopduetothe
oneormoregenresthatacommunitypossesses.Asmentionedpreviously,alargeaspectof
reachingfurthergoalsisbuildinguponthosethathavecomebefore,andthatincludesthe
knowledgeaswellasthethoughtsorargumentsthatothershave.Throughmultiplegenreswithin
adiscoursecommunity,agreateramountofpossibilitiesareavailableinregardstowhatstepsto
takeinthefuture.Thisalsocanleadontoanincreasingnumberofrhetoricalsituations,anyof
whichcouldbereactedtoinamultitudeofways.Whiletheconceptsthemselveshadbeen
mentionedontheirown,itistheirrelationtooneanotherthatshowcasestheimportanceofeach
conceptinthisanalysis.Althoughitwouldbetruetosaythattherearemanyreasonsastowhy

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medicalcasereportsareagenre,itismuchmoreconvincingthroughthegivenevidenceseenby
itsexigenceaswellasitsplaceinthediscoursecommunity.Theseshowthereportsareindeeda
keyfigureofthelinkedconceptsandplayanimportantroleasagenrewithinthecommunity.

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WorksCited
Devitt,AmyJ.,AnisBawarshi,andMaryJoReiff."Materialityandgenreinthestudyof
discoursecommunities."
CollegeEnglish
65.5(2003):541558.
GrantDavie,Keith."Rhetoricalsituationsandtheirconstituents."
RhetoricReview
15.2(1997):
264279.
Hammad,Ahmed,etal."Acutelegpainwithsuspectedbeginninglegcompartmentsyndrome
anddeepveinthrombosisasdifferentialdiagnosesinanunusualpresentationofBrodies
abscess:acasereport."
Journalofmedicalcasereports
9.1(2015):18.
Swales,John."Theconceptofdiscoursecommunity."
Genreanalysis:Englishinacademicand
researchsettings
(1990):2132.