All day long I listen to stories.
Some doctors use genetic analysis or study shadows. Others push laparoscopic trochars. I listen and look for patterns.
Sure I study the intestinal mucosa with fiberoptics. And the physical exam can add something. But the real money’s in the stories.
It’s used to be that stories and patterns drove medicine. Narrative and intuition were all we had. Then came technology and all its precision. But I suspect that as medicine becomes more and more precise, the stories will find their way home.
They say that the future of medicine is personalized. And what’s more personal than someone’s story?
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Dr. V you are spot on. With my 11 year old daughter’s UC, I have learned and come to know the pattern of her flares. It is her pattern that tells me she’s in trouble and needs intervention. Her pattern is her story and it is what a mother/father/caregiver knows and must communicate to a child’s medical team. The patient’s story will drive better outcomes and that defines the goals of patient-centered care. Thank you for bringing this to the fore.
I take the view that stories can be data too. The process of collecting qualitative information in the form of patient stories, combined with figures can help you generate important insights.
You walk on the ward and grab the chart. There lies the e-stuff–printed words, ECGs, rhythm strips, echos and CT scans. Whenever these fail to tell the story, which is often, there’s always the trump card.
Sitting at the bedside and listening to the story.
Very nice my friend.
I recall as one of 140 first year medical students in a theatre watching Robert Tattersall take from a patient a history of some rare diagnosis that I can’t even remember. What I do remember is that he got it all from the history.
Funny that he would appear in my memory twice today…
http://wp.me/p25FwE-2Y
Great writing, Bryan…Thanks.
So true. Ironically I think technology can bring us back that personalized one on one communication which empowers the trusted doctor patient relationship.
Maggie Mahar and I did an essay a few years back about the meaning and importance of patient stories, highlighting the work of one of the most fascinating medical story-tellers, physician-poet Rafael Campo.
Here’s the link, for those interested.
http://www.healthbeatblog.org/2008/06/stories-and-sta.html
I neglected to add a link to Rafael Compo’s wonderful essay about narratives in medicine. Here it is.
http://www.ploscollections.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030423;jsessionid=61E80CBCC0E8867C63C8FF5159A34C77