Bedside manners: paradoxes of physician behavior in grand rounds.

This paper explains some of the routine of grand rounds in a major Israeli teaching hospital. It focuses on paradoxical behavior of physicians and others who participate in grand rounds. Behaviors are explained as boundary marking mechanisms meant to redefine statuses in the hospital and defend the physician from threats to his status. These paradoxical behaviors also function to permit the physician to enter and depart from the more culturally marginal territories of human experience, those which people try to deny or mask in everyday life. In particular, paradoxical behavior arises when dealing with death, waste, and sex. Paradoxical behavior is seen as a means of making a space in which everyday reality is masked and turned into play, creating a boundary between the medical reality and the social world. Paradox and other aspects of the grand rounds serve to restratify and counteract structural breakdown created by the physician's entry into states of pollution.