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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
The Patient, the Doctor, and the Story: The Role of Narrative in Clinical Medicine
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David Hatem, Worcester, MA, USA Associate Professor of Medicine, University of Massachusetts Medical School
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In the course of my workday, I came upon a woman who was not breathing. I administered CPR. Other medical personnel joined me. We functioned as a team. This effort was different than our work in other situations. That other work was often marked by tension and disagreement. It was difficult work. We did our best. We were not successful. She died. This scene unfolds daily in hospitals throughout the world. And then, life goes on, on to the next patient, after a quick break, a conversation to debrief, if we are lucky. The debriefing may go over algorithms. Did we give the right drug? Was it all in the right order? Did we give the patient their best chance to survive? This story focuses on the doctor, what they could have, or should have done. Yet, there is a patient, a doctor, and a story. Considering all of these as done in The Dark Bridal Canopy offers the opportunity to look at medicine in a broader context, and the doctor as significant player in life’s events. In this narrative, we have more detail described than the stark clinical narrative. As with any good narrative, there is a situation and a story (1). The victim is a woman. The victim is a beautiful woman. The woman is beautiful, and is coming from her wedding. The woman’s new husband is with her. The new husband is involved in the accident, and is a witness to the futile attempt at CPR. There are surely other people who will be affected by this event and its outcomes. And the author remembers it in part because of its unusual circumstances (not in the hospital, but in the desert in the middle of the night), and its effect on him, leading him to come home, check on his family, assure himself that they are okay, and then bathe “long and hard-feebly attempting to clean off the pale of death.” (2) Narrative probes the depth of our experience and understanding, yet continues to search for a place in medicine. The beauty we see here is now included in many journals. Only in recent years has there been an effort that begins to tie narrative to a broader role in medicine, to empathy with patients, self-awareness for physicians, the foundations of the medical profession, and to the public trust (3). It is time to move beyond the simple beauty of the story, and describe, then infuse narrative skills into the very fabric of the day-to-day work of medicine. References 1. Gornick V. The situation and the story; the art of personal narrative. New York. Farrar, Strauss, and Giroux. 2001. 2. Borkan J. The dark bridal canopy. Ann Fam Med. 2006;4:75-78. 3. Charon R. Narrative medicine. JAMA. 2001;286:1897-1902. Competing interests: None declared |
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