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This paper investigates the language choices made by contributors to an electronic discussion list on bone marrow transplantation, called SupportBMT, and relates these to the construction of these contributors' identities as survivors rather than as victims of a life-threatening disease and/or of a lifethreatening medical treatment. Specifically, it examines the use of 142 instances of reported speech within 61 narratives posted to SupportBMT that recount conflict within a past medical encounter. Analyses of the illocutionary acts of these instances of reported speech, as well as the alternation between direct and indirect reported speech in these narratives, portray the patient as a strong self-advocate and the physician as contributing to that positive image of the patient, either directly or indirectly. Findings suggest that survivors' use of reported speech within such narratives provides a socialization model for newcomers to the community of those with such illnesses.

To date, research examining adherence to genetic counseling principles has focused on specific counseling activities such as the giving or withholding of information and responding to client requests for advice. We audiotaped 43 prenatal genetic counseling sessions and used data-driven, qualitative, sociolinguistic methodologies to investigate how language choices facilitate or hinder the counseling process. Transcripts of each session were prepared for sociolinguistic analysis of the emergent discourse that included studying conversational style, speaker-listener symmetry, directness, and other interactional patterns. Analysis of our data demonstrates that: 1) indirect speech, marked by the use of hints, hedges, and other politeness strategies, facilitates rapport and mitigates the tension between a client-centered relationship and a counselor-driven agenda; 2) direct speech, or speaking literally, is an effective strategy for providing information and education; and 3) confusion exists between the use of indirect speech and the intent to provide nondirective counseling, especially when facilitating client decision-making. Indirect responses to client questions, such as those that include the phrases "some people" or "most people," helped to maintain counselor neutrality; however, this well-intended indirectness, used to preserve client autonomy, may have obstructed direct explorations of client needs. We argue that the genetic counseling process requires increased flexibility in the use of direct and indirect speech and provide new insights into how "talk" affects the work of genetic counselors.

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Both a linguistically-informed investigation ofthe dynamic process of identity co-construction in individuell conversations äs well äs a linguistic approach to intertextuality across conversations are necessary for a more complete understanding ofthe critical r öle that language plays in the establishment andmaintenance ofrelatively stähle social identities for theparticipants in these conversations. This argument is illustrated by examining the co-construction of peer and patient identities within and across two naturally-occurring conversations held six months apart between one eiderly woman diagnosed with Alzheimer's disease and the researcher.