This paper, as part of a growing body of studies that investigate translingual communicative practices, introduces a microanalysis of doctor-patient interactions that took place in urban Japan, a country that has been identified as belong to the expanding circle of world Englishes (Kachru 1986). Through the examination of two cases of primary care visits, one conducted in lingua franca English and another in a hybrid of Japanese and English, the study demonstrates how a Japanese doctor and two migrant patients from Ghana skillfully deploy a variety of semiotic resources to achieve the problem presentation stage of their encounters. More specifically, it investigates how concerns expressed by the patients become constructed into ``doctorable'' (Heritage and Robinson 2006) medical conditions through their subsequent interaction. The turn-by-turn examination of interactions reveals how the doctor's biomedical knowledge, embodied in his interactional practices, together with his cooperative disposition (Canagarajah 2013) to the interactional uncertainty inherent in multilingual and multicultural encounters, serve as a critical vehicle for making both the doctor's and the patients' seemingly ``truncated multilingual repertoires'' (Blommaert 2010) work in this particular institutional context.
Applied Linguistics Review serves as a testing ground for the articulation of original ideas and approaches in the study of real-world issues in which language plays a crucial role by bringing together critical reflections of current debates and new theoretical and empirical research. Topics range from aspects of the linguistic and communicative competence of the individual to language- and communication-related problems in and between societies.