May 17, 2019 in Medicine

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The importance of telling stories in medicine is to enable doctors to attend to the patients’ problems in a more precise and accurate manner. Doctors listen to stories from their patients that are privileged to their private lives or the lives of others. However, most of the physicians are less concerned with expressions conveyed by the patient in narration to an extent that they gather very little information in providing prescriptions and treatment.

Understanding a patient means listening as the patent speaks and relating how the patient’s words reflect their medical life history. It helps the doctors understand how the health condition fits into the personal narrative. Listening and sharing information with the patients provides the doctor with the symptoms’ cues, which can be derived only from the linguistic narration of pain. Most doctors are dedicated to care and understand what happens with their patients in order to deliver an adequate treatment. The narrative sense of medicine and the fine art of storytelling and listening should be emphasized to provide an effective treatment.

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In clinical medicine, storytelling has a long history. Medical authors from Hippocrates to Osler transmitted their insight and pearls in the form of prose when compelling stories of common illnesses. By sharing stories of patients with others, such as care providers, medical students, we prevent similar harms from occurring. We have regularly watched in awe transformation that takes place in the care centers. These stories ignite conversations around common medical errors that become prerequisites for change at that moment.

Narratives in Medicine

Hippocrates laid down the foundation of replacing supernatural theories with natural practice in the field of medicine. He proposed the theories of disease causation that emphasized the physician talking with the patient. Traditionally, the principles of western medicine dictated that the physician should perform palpation of the abdomen and urine test before engaging in conversation with the patient. However, this tradition did not take into consideration superficial narrations of Hippocrates and the resultant medicine regardless of the nature of conversation between the doctor and the patient (Brody, 40). Conversation between physicians is surely important to the medicine and it commonly takes place in terms of storytelling.

It appears that relying on historical case studies has been weakened in the contemporary medicine due to the presence of strong scientific researches. However, the transition from the traditional anecdote to the modern scientific theory has been effective in some instances and failed in others. In some cases, stories have proved essential as a means of perceiving how scientific knowledge, in general, has been applied to specific individuals to aid healing. For instance, Richard Selzer has used writing as a tool for illustrating the essential features of surgery through short stories, which has proved to be quite important in developing the quality of service. In real-life cases, there are few surgeons who have time to sit in the office and tell narrative with intimate details because patients are on the operating table one after the other, and little time is left to relax. Thus, surgeons remain the most insightful physicians whose storytelling experiences can change the approach to effective medicine.

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The ritual that devalues a storytelling technique may take several forms and most of the times it is a patient who is blamed for any misfortune. Most overworked and hurried physicians have little tolerance to any information that the patients provide that may not be related to the context or translatable. If to assume that storytelling in medicine is not important in our subconscious world of the doctors, it is necessary to accept the fact that our doctors have to end their day activities completely tired and frustrated. Besides, they might succumb to the temptations of telling stories of their patients in social settings outside their practice. The intention of narrative in medicine is intended to be applied in the entire discipline. However, it is not surprising that psychiatrists, particularly psychoanalysts, devote more explicit attention to storytelling, which has raised more concerns about its epistemology.

Storytelling as a Medicine

According to Trautmann (43), in her book Healing arts in dialogue: medicine and literature, there is a high level of relationship between medicine and literature. The inclusion of literature in the art of healing is legitimate since there are various ways, in which storytelling is identified with healing activities. For example, suffering is created and alleviated basically by the meaning that a person attaches to experience. The basic mechanism for attaching meaning to specific experiences is to give a story that relates to them. Stories help in relating personal experiences to provide expository constructs to the society and culture as well as provide experiences within the confines of specific life history.

The purpose of telling narratives is to allow the doctors to label some experience of representing an act of religious or cultural devotion. The other purpose is to allow categorizing experiences completely connected with the character of childhood to the present medical situation of the patient. The meaning of experience to each person is that it provides a sense of responsibility that partakes to the fulfillment of professional obligations in medicine.

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Researchers have extensively argued in detail on the ubiquitous features of medicine that may be referred to as the placebo effect. It occurs to a higher degree when the signs of illness are altered in a more positive direction. This type of healing includes bodily changes and often is not restricted by the patient’s independent impression as documented in the medical literature about placebo effect. The notion of positive changes in the meaning attached by the patient to the experience of illness can be categorized into three closely related and distinguishable components.

  • First, the experience of illness must be explained in a manner that can be viewed acceptable provided the patient’s belief connects to the existing views of the world.
  • Secondly, the patient has to understand that he/she is surrounded by a group of caring people who he/she may rely upon in future for the sake of his/her treatment.
  • Thirdly, the patient has to achieve a sense of mastery of his/her illness experiences either through feeling powerful enough personally to change the course of events for the better or through the feeling that his/her individual situation of powerlessness can be compensated for by the knowledge and power of some caring individuals of the group.

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All these factors can present both positive and negative sides of storytelling in medicine and affect how narratives determine medicine practices. Alteration of the status of beliefs or meanings can result in either dissolution or physical healing of the body. Physicians are not the only social figures employed to relieve the suffering of patients. Stories can also be used by many other professionals in medicine to reassure and comfort the patient by giving meaning to previously inexplicable and frightening experiences of the patient. Religious myths and stories that attribute causation to the past transgressions, as well as promises of future redemption, are perfect examples.

Illness as Metaphor

According to Susan Sontag (89), there is a concrete relationship between illness experience and disease metaphor in contemporary western society. She viewed metaphor as something that can render diseases socially and physically mortified. This discovery has influenced a generation of psychiatric researchers and scholars. Despite the eloquence in the prose and the force behind the writer’s conviction, her conclusion is not entirely persuasive. She concluded that cancer patients are more ashamed and silenced by the metaphor and this assumption has shaped public perception, particularly of neoplastic diseases.

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However, potency of Sontag’s vision, explanation does not necessarily follow the conclusion about impact of disease metaphor as always reliable. Most people were afraid of Sontag’s experience in the field of medicine. To be sure, more physicians prefer to dissemble issues relating to cancer while the cancer victims shun the diagnosis that they feel more equivalent to death. Considering a story of a doctor told to a patient in Ontario suffering from rectal cancer in his death bed. The patient had refused to undergo colostomy due to the contemporary belief that any treatment would lead to death.

Undoubtedly, illness as a metaphor provides a powerful alert to the existence of diseases and metaphors, but the illustration molded understanding about the illness experience. In the American history of cancer, James Patterson developed and reinforced the central argument presented by Sontag that cancer patients have suffered in silence for a long time resulting to stigma (Gawande 56). Sontag failed to present importance of communication and storytelling in the field of medicine. Such a conclusion could have been avoided by presenting various stories that try to illustrate theories and beliefs that are related to cancer.

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