Borrowed language and identity practices in a linguistic marketplace: A discourse analytic study of Chinese doctors’ journey online

Abstract

This article examines online identity practices of Chinese doctors mediated through borrowed linguistic resources in a leading medical app. Setting against rapid societal changes in China which open up traditionally ‘powerful’ professions to market competition, and the development of a booming digital economy, this app and its semiotic work drawing on Chinese Internet vernacular, I will argue, offer a fascinating lens to probe into the highly dynamic online discursive practices in contemporary China. Drawing on the notions of entextualization and resemiotization, I will trace and analyse the patterned ways in which pre-existing linguistic resources are creatively reworked by the app to achieve new identity-making purposes. Situating the changes of the field of healthcare in China within a worldwide shift towards neoliberal ideologies and practices, I will also briefly discuss how the emergence of such new social space in digital settings may impact the production and communication of health knowledge and services in China.

Keywords

Chinese Internet vernacular doctors Mainland China popular science article professional identity sociolinguistic resources

Introduction

In recent years, digital industry in China has undergone unprecedented developments and turned out numerous online and mobile applications, which are easily accessed by a very large population.¹ The highly sophisticated and powerful functions of these applications have effected tremendous changes on Chinese people’s everyday life. Moreover, rapid social changes and economic restructuring are increasingly opening up previously state-controlled professions to market competition, which is now more mediated through digital than other traditional platforms. One strand of current research on digital culture focuses on the so-called ‘light’ communities built through ludic practices by the kinds of technology savvy social actors, who can acquire, through online interactions, opportunities of success hard to acquire elsewhere in society (Blommaert et al., 2019; Blommaert and Varis, 2015; Lu, 2018). It is also observed that identity construction through employment of playful language and online memes is practised by those actors, who are already powerful offline (see Zhang, 2012, 2015b). Given these phenomena, how can we better understand such discursive practices and power dynamics, which cut across both powerful actors in the traditional sense and the newly emergent social groups? In a way, social media platforms on the Chinese Internet can be seen as a highly dynamic and intensive linguistic marketplace (Bourdieu, 1977) where discourse itself, as a form of ‘searchable talk’, has become a valuable commodity (Zappavigna, 2011) for both elite groups and ordinary people. In fact, the practices of self-branding and micro-celebrity management depending on visibility (Marwick, 2010) can be widely observed on the Chinese Internet.

This article studies the online journey of Chinese medical professionals — newcomers to this online linguistic marketplace and their identity-formation processes realized with ‘borrowed’ linguistic resources from elsewhere. There is now a growing body of sociolinguistic work dedicated to the study of how the meaning potential of socially imbued linguistic features derived from pre-existing resources is explored and transformed by other groups to make new meanings and associations (see review in Bucholtz and Hall, 2005). Building on these lines of research, I aim to investigate how the particular conditions in a rapidly changing Chinese society including economic restructuring, high rates of Internet participation and the opening up to competition of previously protected professions serve to illustrate the disruptive and productive potentials of the Internet in general, and shed light on the discursive construction of professional identities online. Moreover, I will offer a detailed case study of how linguistic resources associated with some groups are appropriated by other groups, and explore how socially and historically imbued meanings and associations are recontextualized to serve new identity-making purposes, not confined to those currently much-studied light communities. At the same time, I will also discuss the benefits and stakes of trying to use and ‘own’ a new language, especially when it is incongruous with the established image of the group. Overall, it will be demonstrated that these online practices are not merely reflective of, but also partially constitutive of, the emerging orders of Chinese society in that they give rise to new relationships, communities and social realities, as well as impose divisions and hierarchies.

Background

Chinese doctors’ transition from danwei ren to shehui ren

Unlike its western counterparts, doctors in China are largely bound within state-owned public hospitals (holding more than 90% of the market share; see Zhu, 2018) and lack flexibility in their professional practices on many different levels (Yang, 2017). Together with civil servants and teachers, doctors have long been taken as the prototype of 单位人 (danwei ren, ‘danwei person’). Danwei, 单位, literally meaning ‘unit’, is a notion heavily grounded in Chinese socialist practices (Bray, 2005). Because of its wide-ranging political, judicial, civil and social functions, danwei used to be, and still is in some cases, the principal source of identity for urban residents (Perry, 2015).

A major change in Chinese medical and healthcare system, which significantly reshaped doctors’ danwei, took place in the 1980s (Duckett, 2011: 50). A nationwide contractual system of healthcare institutions was founded to alleviate financial pressure on the state by encouraging each and every institution to self-finance. In consequence, despite being a danwei ren in a state-owned medical system, doctors have to endorse a market-driven mentality in order to increase income. Not officially in the market, hospitals are quite constrained in their income-generating practices – a common solution adopted is collaboration with pharmaceutical companies, who pay doctors kickbacks to prescribe their medicine (Jiang and Fan, 2002; Li, 2018b). In this distorted system, some doctors are heard complaining about their role of being danwei ren: they are not treated as an employee in a legal, contractual sense, but as a cadre to be strictly managed by a state-controlled work unit; they are encouraged to be corrupted, instead of holding up the moral standards of being a doctor (Li, 2013; Tang, 2014). In order to improve the situation, several recent medical reform initiatives call for the transition of doctors from danwei ren to shehui ren (社会人, ‘members of society’). This means to move doctors out of the institution, diversify their roles through multipractice licencing and increase their mobility from the public to private sectors (China State Council, 2016). On another level, to increase doctors’ mobility is seen as a crucial step in hospitals’ marketization, which will eventually enhance hospital services through competition and return the doctors to their ‘original’ role of being a doctor. This restructuring in China can also be read as part of the global move within the field of healthcare towards neoliberal ideologies and practices, which endorse ‘individualism, free market via privatization and deregulation, and decentralization’ (McGregor, 2008: 82). However, one major challenge in this transition is, these doctors lack experiences and skills in collaborating with the market capital. Not ready to take the full risk, they hesitate at the prospect of completely leaving the danwei behind (Zhu, 2018) and choose to strategize in both ways: keeping the institutional role while exploring other roles to build a brand in the private sector, increase income and test out career development ideas. Online medical platforms provide an attractive outlet for such purposes (Fang, 2018).

Mobile medicine, popular science articles and the use of Chinese Internet Vernacular

As noted in recent publications (Hsu et al., 2016; Milcent, 2018), mobile medicine seems to provide inspiring solutions for China to cope with its many difficulties and problems in healthcare services and management (including, in addition to those mentioned above, chasm between large cities and rural areas, and a rapidly ageing population). CH Doctors, the medical app that I study in this article, is one of the many emergent digital platforms for ‘liberated’ doctors and entrepreneurs to tap into the great potential of mobile medicine.

CH Doctors, founded in 2014, is of special interest to this study due to its highly successful identity-building and image-branding work. Aiming at ‘providing reliable and trustworthy healthcare information’, the app boasts of a strictly selected doctor base and a peer-review system managed by experts and professionals drawn from a range of medical fields. In the early stages of its development, the team has already gained a well-established social brand through multimodal content production in the form of popular science articles. Medical professionals as authors are identified with real name, area of expertise and affiliated institution (sometimes their photos are attached). Obviously, it is not new for professionals to communicate science to the wider public; what is new on this app is its highly scripted and orchestrated brand-making and identity work, managed with a conscious strategy to hammer out a distinct online presence of the app and its doctors.

Seeking to ‘provide professional content using human language’, these popular science articles combine two different sociocultural frameworks — techno-scientific explanations and entertaining, relational readings. The authors are highly skilful in navigating within and between these two discursive realms by making use of the meaning potential that different semiotic resources afford (including cultural discourses, argumentative textual patterns, Internet memes, scientific genres and discourses, still and moving images, and multilingual forms). Most strikingly, to varying degrees, all articles draw on Internet language and try to be funny.

Although, as Locher (2006) points out, health advice columns have a long tradition of using entertaining elements and strategies, this discursive practice used by CH Doctors needs to be socially and historically contextualized against China’s science communication policies and practices. As observed in Zhang (2015a), with an overpoliticization of science and of science communication in China, scientists often feel an ‘obligation to adhering Party rhetoric’ when interacting with the public (p. 917). Science popularization platforms are also commonly treated as important channels to promote socialist thinking and values.² Therefore, the use of attention-grabbing perks and entertaining elements (as prevalent nowadays on social media platforms) can be seen as incompatible with socialist work ethic and often frowned upon by serious and conservative professionals (Luo, 2014; Yan, 2010); in particular, the use of nonstandard language and irregular expressions (typified by the Internet language) on public media is at times condemned as undermining core socialist values (Xinhua Net, 2015). Viewed against this background, the medical app’s deployment of Chinese Internet vernacular (hereafter CIV) constitutes a daring, new practice. By focusing on the app’s use of borrowed resources from CIV, I expect to address the following questions: (1) How is the tension between professional communication and ‘unprofessional’ use of language managed in this app? (2) How are CIV resources actually used on the app, serving what specific semiotic functions? (3) With the combination of CIV and other resources commonly used in popular science articles, what distinct professional identity of doctors does this app construct? (4) In what ways is this new identity a response to the wider structural, social changes towards neoliberalization in the field of healthcare in China?

Now I will briefly introduce some background information on CIV to prepare for further discussion. Despite its fluid and ever-changing nature, CIV, referring to neologisms or discourse patterns originating from Chinese Internet communication, is increasingly being recognized as a distinct register (Bian and Gao, 2012; Gao, 2012; Hu et al., 2014; Yang et al., 2015). Nie’s ethnographic and sociolinguistic study of CIV (Nie, 2018) examines the multilayered and ever-evolving enregisterment process of CIV as a reflexive process. Drawing on previous works, he claims that the recognition of CIV as a register mainly lies in its opposition to the standard language that is endorsed in the official discourses, due to its sociocultural and symbolic function as expression for self-empowerment, collective anxiety and forms of resistance, and populist cultural identity (Nie, 2018: 150).

It is worth noting that though the creation and use of CIV is mainly associated with visible and identifiable sub-communities on Chinese social media, it is rapidly becoming a form of shared resource readily available in the linguistic marketplace for different platforms and parties to adopt. The speed and scale of how viral words and discourses travel online, taking on new enregistered meanings in a way which ‘defies any linear prediction’, are also highlighted as important features of CIV (Nie, 2018: 14). In this article, I will treat CIV as ‘sociolinguistic resources’ (Blommaert and Backus, 2013) that individual users actively appropriate for themselves to achieve various purposes.

Despite the diverse group of authors on the app, CIV resources are applied in a similar pattern across a range of articles (more details are shown in the ‘Data Analysis’ section). Although in this study I cannot verify whether these similar applications of CIV are added afterwards by the editorial team, it is not unlikely considering the close collaboration between this team and media promotion professionals (especially humour production companies). Since the focus of this study is the identity work achieved through semiotic constructions in popular science articles, precise information about the factual author seems less important than the actual, named author because that is what the constructed voice, positioning and identity are expected to be attributed to. To underline the complexity regarding authorship, hereafter I will use the term ‘doctor-author’ to address the (multiple) author(s) of the articles.

Key concepts and analytic orientations

As mentioned earlier, the essential role of language and discourse in identity-making is widely recognized and studied in sociolinguistics (De Fina et al., 2006; Dong, 2011; Rampton, 1999; Wodak, 1997). Adopting a perspective which sees identity as emergent through discursive and interactive practices, instead of pre-given, these research examine in minute detail how in specific interactions, various semiotic resources are utilized to make new indexical links, which then call into being the social practices of identities. As reviewed in Bucholtz and Hall (2005), a large body of research demonstrates how identities emerge in situations through the study of the extreme cases where speakers’ language use does not conform with the social category to which they are normatively assigned (including cases of transgender identity, cross-gender performance and ethnic, racial and national boundary crossing). They comment that such cases are striking because they sever the ideologically expected mapping between language and biology or culture (p. 588). This line of enquiry provides an appropriate framework to study the salient use of CIV on the medical app, since it is not a register commonly associated with medical professionals. Moreover, we can examine in depth how the borrowed language with its sociocultural associations imbued through enregisterment processes is creatively recontextualized in new situations of use and takes on new meanings, while serving the purpose of branding and identity-making in mobile medicine.

Furthermore, to capture how borrowed resources are actually used by the doctor-authors to make new indexical links and perform identities, I will make use of these two notions, entextualization and resemiotization. Drawn from different disciplines, both terms are proposed to trace the circulation and appropriation of complex multisemiotic material through social actors’ meaning-making efforts. Entextualization can be understood as the process of first rendering discourse ‘detachable from its local context’ (Silverstein and Urban, 1996: 21) and then repositioning it as a new unit which carries ‘elements of its history of use within it’ (Bauman and Briggs, 1990: 74) in a new context. Resemiotization, proposed as a complementary perspective to the theory of multimodality (Kress and van Leeuwen, 1996), seeks to trace ‘socio-semiotic histories and transitions’ (Iedema, 2003: 48) through the examination of meaning’s ‘making shifts from context to context, from practice to practice, or from one stage of a practice to the next’ (p. 41). In a similar vein, Scollon and Scollon (2004, see also Scollon, 2008) use it to map changes occurring in different discursive processes: discourses resemiotized into objects, objects further resemiotized into discourses and actions, and so on.

In what follows, I will draw on these two notions to analyse how doctor-authors entextualize and resemiotize borrowed CIV resources in new contexts to construct roles and identities for themselves and the readers. Moreover, the benefits and stakes of trying to use and ‘own’ a borrowed language and implications for identity construction will also be discussed in light of some readers’ comments.

Data and methods

This article is part of an ongoing study of digital health communication in China. The total number of articles from the app that I have examined for this paper is 100. The data were collected over a period of 10 months (July 2017–May 2018). The dataset has exhausted all relevant articles that I could access on the app during the period, and the topics range from cancer treatment to dietary habits. Considering the ethical implications of using open access data for research (see Bolander and Locher, 2014), all identifying information concerning the app, the doctor-authors are anonymized in this study.

Each article (around 1800 words in length) can be seen as a front-stage environment (Goffman, 1959) where the doctor-author’s online professional identity is performed (Page, 2012). They tend to follow a recognizable four-part format: (1) Introduce a common health practice (based on traditional Chinese medicine, indigenous folk knowledge or popular trends); (2) Label it as misleading, incorrect or harmful; (3) Provide scientific explanations; (4) Make recommendations from the perspective of CH doctor. This format fulfils the core semiotic functions of a popular science genre: to deliver scientific knowledge with accessibility and visibility (Gotti, 2014; Hyland, 2010), while as will be shown below, this established genre of popular science is appropriated on the app to achieve a diverse range of informative and relational purposes.

Now I will describe the steps of the analytic process of identifying in the corpus CIV, which, as discussed above, constitute important resources in doctor-authors’ identity work. Although, generally speaking, Chinese speakers, especially those active on the Internet, can intuitively identify resources drawn from CIV, official reference books on CIV do not exist. There are, however, several widely cited sources, including major websites, government reports and reputable publishers which provide information on the source, meaning and usage of individual items.³ In this study, I start with identifying and coding CIV terms in the articles by drawing on my personal knowledge, then I search online and check whether any reliable source has listed them as originated from CIV.⁴ Following that, a detailed reading and coding of the corpus were conducted to trace the patterns of how CIV is utilized across the articles. As discussed earlier, the doctor-author’s use of CIV instead of standard language can be read as a daring, new discursive practice, so potentially all CIV terms used in the articles can be studied in terms of their distinct, identity-making semiotic functions. However, for a more focused presentation of the research findings, in this article I pay attention to selecting those typical and representative examples based on the following considerations: in which parts do CIV resources tend to be concentrated? What kinds of CIV discourses and terms are used? How are they recontextualized and resemiotized, serving what functions essential to doctors’ identity construction which well go beyond ‘just being funny’?

Data analysis

After an in-depth analysis of the corpus following the steps above, I found that resources from CIV are strategically entextualized and resemiotized in two patterned ways to serve identity-making purposes: (1) They are used in the title and opening paragraphs to position the readers as victims of misleading knowledge and practices, and doctors as their protectors; (2) They are used in the concluding parts to construct an image of the doctor as cute, humorous, sophisticated and amiable professionals. It is also observed that these resources are transformed and seamlessly combined with other textual and semiotic forms commonly associated with popular science genres to construct a new online identity for Chinese doctors.

Positioning the readers as victims, and doctors as their protectors

In the title and opening lines of the articles, the readers are often directly addressed in the second-person pronoun and cast as the victims of misleading sources of information and knowledge, which the doctor-authors are set to debunk. This attention-grabbing discursive move serves to reinforce the distinctness of this app, with its doctors serving as guardians of knowledge against bombardment of incorrect, outdated, misleading sources from both online and offline. An important resource used for this purpose is a series of CIV terms. Below I will analyse two examples featuring the use of one distinct CIV structure (in bold, my emphasis) which is metapragmatically typified as the social voice of the wronged victim.

(1) 母乳喂养的八大误区：你被「奶水不足」了吗？

[. . .]

误区四：胸小的妈妈没奶水

[. . .]

其实，大胸没有那么神秘，从解剖学角度分析，不过是多了些鲜亮明黄的脂肪组织，而内部真正负责产奶的乳腺组织，所有女人都一样。

Eight mistakes in breast-feeding: are you bei ‘breast milk not being adequate’ ?

[. . .]

Mistake four: small-breasted women do not have breast milk

[. . .]

In fact, the big breast is not so mysterious. From the anatomical point of view, it only has a little more bright-colored adipose tissue, while the breast tissue that is actually responsible for milk production is the same for all women. ⁵

(2) 男人你「被早泄」了吗？

不管是事业还是家事，男人最怕被别人说「不行」，特别是在做床上运动时，如果早泄，绝对是对男性相当大的打击。

[. . .]

要想正确认识假性早泄，就必须彻底了解什么是真正的早泄。

[. . .]

关于「早泄」，国际上最权威的当属国际性医学协会（ISSM）2014 年发布的早泄诊断和治疗指南，「早泄」作为一种男性性功能障碍，它的统一定义由以下三部分组成。

Man, are you ‘bei premature ejaculation’ ?

In both professional and private domains, it remains the biggest fear for men to be thought as ‘not capable’, especially when it comes to activities in bed. When they are labelled as premature ejaculation, it will be a terrible shock.

[. . .]

We need to thoroughly understand real premature ejaculation in order to recognize pseudo-premature ejaculation.

[. . .]

About ‘premature ejaculation’, according to the premature ejaculation diagnosis and treatment guidelines published in 2014 by the most authoritative organization in this field, the International Society of Sexual Medicine (ISSM), it is a male sexual dysfunction and its uniform definition consists of the following three aspects.

These two extracts contain a popular CIV usage: so-called irregular ‘bei phrase’ (被, bei, a preposition to construct passive forms) composed of passive forms of intransitive verbs or even descriptive terms. This unconventional structure was initially used on the Internet to emphasize the citizens’ passivity and victimhood, despite what official reports say.

Its very first appearance is commonly assumed to be 被自杀 (bei zisha, ‘bei suicide’). Associated with a widely discussed case in 2008 in which a prisoner (who reported local officials’ corruption deeds) was declared by the police and procuratorial authorities to have committed suicide, this term was coined by netizens to question the validity of such claims. Their reasoning was, the prisoner did not have a motivation for committing suicide; therefore, if he did commit suicide, it could only be a kind of ‘bei suicide’, which pointed at the suspicious nature of the case. This innovative phrase, a resemiotization of social events produced by netizens’ collective meaning-making efforts, powerfully underlines the netizens’ resistance against and parody of the so-called official accounts. As Li (2018a) comments, it is exactly the paradoxical claim embodied in this irregular bei phrase that is exploited to express a strong satire and social critique. Consequently, through intensive cycles of entextualization and resemiotization, many similar expressions such as 被富裕 (bei fuyu, ‘bei rich’), 被就业 (bei jiuye, ‘bei take an employment’) were coined and widely spread online as (sometimes multimodal) memes, highlighting situations where one does not have control over the things happening to oneself and the claimed actions did not really happen. As observed by many Chinese linguists, netizens’ creative play on this structure reflects a deeply felt loss of control, pressure to conform, and distrust of the state and state institutions (Jiang, 2011; Peng, 2011; Shen, 2010; Wang, 2009). To a certain extent, by subverting linguistic norms to make the expression of such unique set of meanings possible, these CIV phrases can be seen as the ‘ludification of culture’, the mocking of authorities, the construction of alternative meanings and realities discussed in Raessens (2006) and Li and Zhu (2019).

It is thus intriguing to see how this CIV usage is entextualized by the doctor-authors on this app. The first example bends the grammatical rules even further by using bei directly before a subject–predicate structure 奶水不足 (naishui buzu, ‘breast milk not being adequate’). In the article, the author mentions that many new mothers are told by their mothers or mother-in-laws that their breast milk was not adequate or not good enough; thus, some measures (such as resorting to traditional Chinese medicine) need to be taken. It is worth noting that beliefs and practices drawn from traditional, folk knowledge, guided by elderly female family members (or in recent cases, marketized by postpartum care centres, Ji and Bates, 2017; Levin, 2015), still play an important role regarding pregnancy and postpartum care in China (Zhang and Liu, 2018). Taking a scientific stance, the doctor-author aims at unravelling the traditional myths surrounding breast-feeding. Using this entextualized bei phrase which carries rich associations with victimhood to open the article, the author can effectively bond with readers by establishing them as passive, wrongly labelled and judged by people who claim to have more power and knowledge. The second example addresses the phenomenon of males being labelled by others as suffering from ‘premature ejaculation’. Similar to example (1), the author recontextualizes the irregular bei phrase to sympathize with the male readers who are unjustly labelled. In both cases, through the entextualizations of bei phrase, the doctor-authors potentially build rapport with the readers by recognizing their victimhood at the hands of traditional folk knowledge and the expectations generated.

As shown in the extracts above, having thus positioned the readers, the doctor-authors then proceed with other typical popular science discursive moves (such as explaining scientific definitions, tailoring scientific content to nonprofessional audiences and juxtaposing technical jargons with accessible language; see Luzón, 2013) to further invalidate the unjust accusations and lend moral support to the readers. In fact, through this kind of discursive work (sometimes involving discrediting high-profile experts and companies advocating traditional health knowledge and practices), the app has rapidly gained a reputation as ‘debunker of traditional Chinese medicine’ (Hebei Qingnian Bao, 2018). We can see that drawing on the potent irregular bei phrase which carries powerful sociocultural meanings in contemporary China in combination with other typical popular science resources, the doctor-authors fully recognize and sympathize with the readers in their social, emotional circumstances, and offer them the kind of support backed up by scientific expertise. As illustrated in discursive psychology, emotional engagement constitutes a form of discursive and social action, through which relationships are built, positions made and identities constructed (Billig, 1999; Edwards, 1999; Wetherell, 2012, among others). We can see that, in these two examples, through the recontextualization of highly vernacular, critical and creative linguistic forms drawn from CIV to position the readers as victims and engage with them emotionally, the app builds a distinct identity of the doctor-author. They are significantly different from either the danwei-bound, socialist medical professionals full of noble ideas and cultivated language, or the corrupted, profit-driven and callous image which is scandalized in recent years (Zhu, 2005). CH Doctors builds up a new stance of authoritative health science experts: they are sensitive, sympathetic, humorous, outspoken, close to ordinary people’s experiences and concerns; moreover, they can use up-to-date and trendy Internet vernacular to connect and bond with the readers. Most significantly, positioning readers as vulnerable victims of traditional, folk knowledge and rumours, instead of empty vessels to be filled with scientific knowledge as commonly assumed in science communication in China (Ren and Zhai, 2013), this app clearly distances itself from the mainstream by fully siding with the readers and engaging with them emotionally. To a certain extent, this can be read as a response to the increased marketization of healthcare services, which encourages seeing the readers as consumers to be cared for more than citizens to be educated.

Positioning the doctors as cute, humorous, wise and sophisticated professionals

The second strategy of using CIV terms is realized in the concluding part when scientific explanations are provided to debunk the myths and traps concerning health knowledge and practices, and advices given to readers. The sources of the myths and traps are commonly identified to be traditional Chinese medicine, folk medicine, and online trends and so on. Entextualizing and resemiotizing memes and catchphrases from CIV, the authors set up an intriguing contrast between two highly divergent varieties (techno-scientific professional register vs Internet vernacular). As I will show in what follows, the use of CIV resources, apart from softening the argumentative, technical style with light-heartedness, is crucial to constructing an image of the doctor-authors as up-to-date, funny, cute, relatable yet sophisticated professionals.

(3) 可见大家对于胃癌的早发现是多么不上心，这里必须要敲黑板划重点了，我们一定要提高对早癌的认识，积极预防胃癌的发生，争取胃癌的早发现与早治疗。

Apparently we did not really take it seriously regarding the early diagnosis of gastric cancer. Here I have to tap on the blackboard and underline the key points: we must enhance our understanding about early stages of cancer, take an active role in preventing gastric cancer and strike for an early diagnosis and early treatment of gastric cancer.

(4) 所以CH医生来看图说话，帮你涨姿势。

So today I, a CH doctor, will provide matching words with images and help you boost positions .

Despite their different trajectories on the Internet, both phrases highlighted in bold (my emphasis) are resemiotizations of metadiscursive phrases commonly used in the classroom setting.⁶ Now widely circulated on the Internet (serving the functions of introducing highlights, drawing conclusions and emphasizing specific points), they enregister a hierarchical yet familiar, pedantic yet intimate interpersonal relationship. Using highly colloquial forms of expression, they effectively evoke stereotypical classroom scenarios which hold strong resonances for Chinese netizens, by reminding them of their childhood experiences. For example, in example (3), on hearing the teacher’ exhortation ‘Here I have to tap on the blackboard and underline the key points’, absent-minded pupils eagerly turn to the blackboard so not to miss the most important part. Mediated through these popular tropes, the grown-up netizens have the luxury of returning to the familiar collective experiences of sitting in a classroom, yet without the actual responsibilities and burdens of being a student. Used by doctor-authors on the app, these resemiotized phrases successfully build an image of the doctor as a teacher of science knowledge, who care about readers’ well-being so much that they incessantly and exasperatedly lecture for hours and kindly redraw their attention at important moments, yet reveal, from time to time, a humorous and youthful side by shifting to a more vernacular register. Furthermore, the shared knowledge that in this app setting, neither are doctors teachers, nor are readers under any actual pressure to perform student duties adds an important layer of light-hearted, humorous and theatrical effects to these expressions and potentially softens the dictating, lecturing tone of doctors’ advice-giving.

In addition, example (4) recontextualizes a popular idiom from CIV: 涨姿势 (zhang zishi, ‘boost positions’), a close homophone of 长知识 (zhang zhishi, ‘gain knowledge’), was originally used as a pun alluding to gaining knowledge related to sex positions⁷. Due to its initial context of use, this idiom is imbued with the meaning of learning the kinds of knowledge, which are not always ‘correct’, or one may feel ashamed about learning. Moreover, often used by the learning party after they are taught and feel enlightened, it acquires an extra layer of meaning associated with adopting a humble, self-demeaning attitude, and claiming innocence with a cute, sly tone (since one did not know this kind of thing in the first place). In consequence, this term has gathered rich overtones in 卖萌 (maimeng, ‘playing cute’, a complex cultural phenomenon in China; see De Seta, 2014) and provides a contrastive alternative to its homophone 长知识 (the standard usage now reserved for neutral contexts, indexing seriousness, nerdiness and dullness) even in contexts with no reference to ‘corruptive’ knowledge. Strikingly, this phrase is also adopted in the headlines of some government-run newspapers to attract readers’ attention and play cute, such as ‘跟着习大大涨姿势’ (‘Let’s follow Xi Dada to boost positions’⁸). In example (4) above, entextualizing this CIV term in place of its standard counterpart 长知识, the doctor-author can be seen as performing a highly strategic semiotic act (Bucholtz and Hall, 2005), which seeks to index cuteness, now a pervasive identity marker on the Chinese Internet and among offline urban youth circles (Zhang, 2015b).

(5) 因此，不必过于指责撸 sir 们的手淫行为，否则会加重其思想负担。应该以科学的态度对待，尤其是对还处在青春期的青少年，他们的心理状态还不成熟，应当通过积极沟通引导，培养广泛的爱好和兴趣，避免其对性过于痴迷。

另外，还是要提醒撸 sir 们，找个安静而不受打扰的环境下，再开展你的活动。

总之，手淫行为是一种正常的生理现象，不必大惊小怪和惊慌失措，但应切记：小撸怡情，大撸伤身，强撸灰飞烟灭。

Therefore, it is not necessary to over-blame lu sirs ’ masturbation behaviour, otherwise it will only aggravate their anxiety and stress. Instead, it is better for parents and teachers to adopt a scientific attitude, especially for those young people who are still in adolescence period. Their psychological state has not fully developed. Therefore, we should actively communicate with and guide them to cultivate diverse hobbies and interests, so that they will not become obsessed with sex.

In addition, I have to remind lu sirs : find a quiet and undisturbed environment before carrying out your activities.

All in all, masturbation is a normal physiological phenomenon, and there is no need to make a fuss or panic; however, one should absolutely keep this in mind: masturbating from time to time is pleasant, too frequent can harm health, (while) being forceful will only bring you close to perishing.

This example is found in the conclusion part of an article providing scientific explanations and evidences to normalize masturbation. The purpose is also to reveal the unfoundedness of popular websites and forums dedicated to shaming masturbation, which is taken to be the reason behind all kinds of health issues and personal failures. A bilingual slogan ‘今天是撸 sir, 明天是 loser’ (‘Lu sir today, loser tomorrow’) has been widely spread by these groups. 撸 (lu, ‘take off’), depicting the movement of removing things, is used on the Internet as an euphemistic term for men’s masturbation. The bilingual phrase ‘撸 sir’ refers to men who have masturbation habits. Drawing parallels between ‘撸sir’ and ‘loser’, this slogan plays with the homophonic relation between lu sir and loser and highlights the negative effects of masturbation. In China, ideas about the harmful effects of masturbation on one’s sexual health and mental health are still prevalent among some circles, especially those who draw on traditional Chinese folk beliefs and medicine (Breiner, 1992; Bullough, 2002; Ruan, 2007). In part affected by these ideas, many men, especially younger ones, suffer from self-reproach, low self-esteem and often feel ashamed when it comes to masturbation (Hong et al., 2015). In this example, though the author takes a countering position against these online folk discourses, he uses the same phrase ‘lu sir’ to address them. Perhaps one can interpret this usage in two ways: (1) The author draws on a familiar term from CIV to index his awareness of the negative judgements of masturbation online and close knowledge of the Internet memes, as well as to lighten up the discussion; (2) By decontextualizing the phrase from its other uses and entextualizing it in a countering article, the author seeks to produce new layers of meanings to supersede its traces of stigma. This can be seen as a kind of ‘linguistic reclamation’ (Chen, 1998; Galinsky et al., 2003), where the pejorative epithet ‘lu sir/loser’ is re-appropriated by the doctor-author on the part of its original target.

Moreover, the contrast and tension between two divergent registers are also significant here. In the first paragraph, the doctor-author applies a typical lecturing register commonly adopted in educational books through these wordings ‘adopt a scientific attitude’, ‘actively communicate with . . . and guide . . .’. Following that, he shifts to a different register when directly addressing lu sirs themselves. By using a neutral phrase ‘to carry out your activity’, a highly sanitized and general description of masturbation, in contrast with the socially, culturally, psychologically loaded activity as masturbation can be, and the highly vernacular addressing term ‘lu sir’, the text produces strong humorous effects.

The concluding sentence further enhances these effects. It entextualizes an Internet meme based on an intertextual parody of two classical Chinese texts. The first half, 小撸怡情，大撸伤身 (xiaolu yiqing, dalu shangshen), carries out an intertextual play of a common Chinese idiom ‘小酌怡情，大饮伤身’ (xiaozhuo yiqing, dayin shangshen, ‘light drinking is pleasant while over-drinking is harmful’) by replacing drinking with masturbating. The second half is a playful rendition of a well-known line drawn from a Song dynasty poem, ‘樯橹灰飞烟灭’ (qianglu huifeiyanmie, ‘all the war ships were burned to ashes’). Replacing 樯橹 (qianglu, ‘war ships’) with its homophone 强撸 (qianglu, ‘to forcefully lu’), the parody text ludicrously dramatizes the effects of forceful masturbation. We can see that with its multilayered, hybrid intertextual play drawing on classical literature, idiomatic folk wisdom and parody, this richly indexical Internet meme, thus entextualized by the doctor-author, produces an extremely witty, ludic and sophisticated image of a doctor imparting knowledge and advices. The effects are further reinforced viewing how this paragraph serves to conclude a popular science article otherwise heavily versed in techno-scientific discourses.

From the three examples above, we can see that the application of CIV terms, intertwined with scientific, professional discourses commonly seen in popular science genres, produces hybrid effects and serves various social functions in the doctor-authors’ interaction with readers. They not only potentially facilitate the doctor-authors’ performing medical expertise without sounding authoritarian but also, more importantly, build an identity for the doctor-authors as funny, culturally sophisticated medical professionals who are also extremely savvy about Internet memes and trends to the point that they can navigate skilfully between CIV and other registers to connect with the youth. In particular, they appear to be open-minded, caring and subtle in adopting euphemism, humour and a light-hearted tone to discuss sensitive topics, in strong contrast with the ‘textbook style’ commonly employed by Chinese doctors and other medical professionals (Jin, 2006; Zhang, 2003). Furthermore, the doctor-authors’ unconventional and daring deployment of nonstandard, irregular linguistic forms from CIV clearly distinguishes them from other danwei-bound Chinese professionals who are largely instructed to adopt positive, civilized language in professional practice (Zhang, 2019). For Chinese doctors who are now called upon to make role transitions, this intricate positioning can potentially pave the way for moving beyond the danwei and entering a market-oriented social space.

Discussion and conclusion

I have tried in this article to give a detailed analysis of doctors’ online identity construction mediated through borrowed linguistic resources on a leading medical app in China. In particular, I have focused on the strategic use of CIV and the semiotic functions that they serve in doctors’ identity-formation in this new online social space. As danwei-bound professionals who are called to diversify their practices in response to rapid social changes in recent years, doctors are newcomers to the booming digital market. By entextualizing and resemiotizing linguistic resources which are borrowed elsewhere, they seek to acquire a new set of social positionings and build a different social space which facilitates their transition from danwei ren to shehui ren. As I have shown in the data analysis part, they creatively draw on CIV resources, which tend to flout linguistic norms, side by side with other discursive moves and resources derived from popular science genres. In this process, they successfully produce a heteroglossia of voices (Bakhtin, 1981) accentuating an unconventional, witty, empathetic, Internet-savvy, yet sophisticated and professional identity, which greatly differ from other mainstream images of doctors. The app’s highly purposeful mobilization of diverse linguistic varieties of competing social, political implications (Bailey, 2012) to give shape to this ‘heteroglossia’ attests to its efforts in carving out a new social role for doctors. On the other hand, treading the fine line between mere infotainment (Molek-Kozakowska, 2017) and serious science popularization efforts, the doctor-authors’ heteroglossic voicing of potentially conflicting power structures also points at the tensions inherent in their transition.

I will in the following draw on readers’ comments to discuss one consequence of the app’s use of CIV resources, which to a certain extent reflects the above-mentioned tensions. Due to limited space, a comprehensive discussion of readers’ comments section is not possible in this article. One can see many extolments of the humour and creativity that these doctor-authors demonstrate as well as their debunking efforts. However, one negative comment in the corpus highlights a crucial concern here:

我下载你是给长辈看的。你们的定位是知乎吗？装什么可爱搞怪。首页有这样的文字，不合适。

The reason why I have downloaded your app is for my elder relatives. Are you positioned as Zhihu ⁹ ? What’s the point of pretending to be cute and ludic? It is not appropriate to publish these words on the front page of the app.

In this comment, the reader takes the app to task for using ‘cute and ludic’ words in these articles. Using the word ‘pretend’, this comment tries to illegitimate the app’s identity construction by problematizing its inauthentically using borrowed linguistic resources. The comment also brings into view a specific group of readers, the elderly, and points out that these articles are not suitable for them. Although doctor-authors are not available to interact with the readers in the comment section, other readers take up this comment and defend the article as ‘clearly and coherently written’. These responses and interactions are highly illustrative of the possible challenges and consequences these new types of identity work can face. Indeed, as Leppänen et al. (2014) remark, the capacity of using a range of semiotic resources on the social media can both ‘provide new opportunities for identification, agency and social action’, and also ‘impose new divisions, hierarchies and exclusions’ (p. 39). The elderly as mentioned in the above comment may well be one of the excluded groups in this new digitized linguistic marketplace. Despite what is mentioned in the introduction part, emergent social media platforms provide opportunities for otherwise powerless groups to acquire new discursive and social power, the elderly seems to be a group who are left out. Even complaining, critical comments on their part are only made for them, not by them, as illustrated above. Ironically, it seems to be the case that this medical app is widely recommended to the elderly so they will not be trapped by the pseudo-science and outdated traditional knowledge on healthcare (Yanzhao, 2018). It is highly likely that the elderly, a more vulnerable group healthwise, thus in more need of the app if the app delivers what it claims to, may not be its target consumers in the app’s design. This reveals a deep inconsistency between the app’s claimed positioning and its profit-oriented discursive practices targeting younger customers in digitized markets. It is thus worth pondering how the emergence of such apps can shape in a subtle yet profound way both the production and provision of health knowledge and services in China. Furthermore, the implications of the app’s promoting modern science as the absolute truth to debunk alternative forms of health knowledge and practices in a dualist fashion need to be considered, especially in the contexts of China, where there has always been a pluralist tradition.

Lastly, regarding doctors’ identity construction in these new semiotic spaces, one may ask, when CIV resources can be entextualized and resemiotized by a growing number of social actors from various backgrounds, when medical science knowledge risks becoming click bait and infotainment to be consumed, to what extent are these named doctors ready and willing to authenticate these new identities if called upon individually? And to what extent can they be well integrated in their other identities and eventually facilitate the transition from danwei ren to shehui ren? Further studies combining sociolinguistic and ethnographic methods are needed to achieve a deeper understanding of these questions and the issues of authentication and authorization.

Footnotes

Acknowledgements

I would like to thank Andrew Sewell from Department of English, Lingnan University for insightful comments on an earlier draft of the paper. I am also grateful for the detailed reviews from two anonymous reviewers, which helped to improve the quality of the paper.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Notes

Author biography

Feifei Zhou is an assistant professor working in the Department of English at Lingnan University, Hong Kong. Her research interests include theories of language and communication, health communication and linguistic landscapes. Her research monograph titled ‘Models of the Human in Twentieth-Century Linguistics: System, Order, Creativity’ is published in 2020 with Springer. This article is one of a series of articles that she has been writing for a project on digital health communication in contemporary China.

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