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Background and Objectives: This study posits the continued emergence of polysemy, the phenomenon where a single word carries multiple meanings. It is a fundamental characteristic of languages that reflects semantic evolution and improvement. Among several polysemous words in English, “sick” stands out given its various interpretations, ranging from its prototypical sense of "physical illness" to such extended meanings as "disgust" and even "superbness.” While native speakers rely on contextual cues to distinguish these meanings, English as a Lingua Franca (ELF) speakers, who engage in cross-cultural communication, may interpret them differently. This study investigates the gap between its contemporary digital distribution and its reception among ELF speakers. Rather than claiming these senses are novel, this research aims to quantify the prevalence of the prototypical sense of "physical illness" alongside established extended meanings, namely "disgust," "boredom," and "superbness,” in modern social media discourse. By applying the Principled Polysemy Approach by Tyler and Evans (2003), the study unveils how these senses are retained or filtered by ELF users in intercultural communication. Methodology: To analyze the extended meanings of “sick,” the researcher manually collected all the data from social media posts and reel captions on Facebook, X, and Instagram. The obtained instances were investigated to verify the word’s prototypical meaning and its extended meanings. To reveal ELF speakers' perceptions, on the other hand, an online survey was conducted, with ELF participants being reached online and identified as non-native speakers of English. The survey contained questions that purposively assessed their familiarity with and usage of “sick” in various contexts. Main Results: The results confirmed that “sick” maintains its prototypical meaning of physical illness while obtaining three non-prototypical meanings throughout the analysis: "to feel disgusted," "to feel bored," and "to be superb." It was moreover noted that ELF speakers predominantly associated sick with its prototypical meaning, and they also recognized and employed its extended meanings to some extent simultaneously. Discussions: Even if polysemous words can have extended meanings over time, like “sick” does, their adherence to the prototypical meaning is always explicit, as aligning with the prototype theory as well. In addition, it was found that the perceptions of the word “sick” among ELF speakers were not distant from prototypical association with physical illness. The speakers’ non-literal senses of the word on digital content indicated their interpretation of “sick” over its foundational meaning, which is often in health-related situations. Besides, in ELF settings, communication effectiveness is prioritized over stylistic novelty, reasoning why the word sick can be interpreted differently despite being in the same context, remarking an important role of intelligibility in interactions. Conclusions: The study highlights how polysemy is perceived in ELF communication, providing insights for lexicography, English language teaching, and international communication. The rise of three new, non-prototypical meanings of this only single word “sick” strenuously confirms possibilities that words can keep evolving both semantically and morphologically, in line with the constant creativity of speakers of languages, whose needs for lexical innovation in response to various purposes seem to know no bounds.