Stories of Illness and Healthcare from a Physician Perspective

Stories of Illness and Healthcare from a Physician Perspective

J. Huw C Morgan (Consultant in International Medical Education, UK)
DOI: 10.4018/978-1-60960-097-6.ch010

Abstract

Doctors have unique and privileged opportunities to observe and participate in the illness narratives (stories) that patients present with. Hearing, understanding and respecting the patient narrative is as important as correctly practising the technical aspects of medical diagnosis and treatment, and yet traditionally has received much less emphasis during medical education. The stories below (which have all been altered to preserve patient confidentiality) illustrate how attention to the patient’s narrative enables a richer and deeper interaction with them that enhances the therapeutic aspects of the consultation.
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Introduction

We shall not cease from exploration
And the end of our exploring
Will be to arrive at where we started
And know the place for the first time. (Eliot 1967)

A doctor spends the majority of his working life in face to face contact with people. Every year he has thousands of consultations with the members of his practice population. He shares their pains, their sorrows, their fears, hopes and (sometimes) their joys. Whilst many of these consultations may not involve issues of any great consequence or significance, there are a number that do. They may not occur every day or even every week, but over the course of a month there will certainly be a few occasions when both patient and doctor feel that together they have touched on something profound; that the nature of their communication has resulted in a degree of real human contact that transcends the mundane. The way the patient uses (or fails to use) the resources of themselves, their religious faith, their family, community and friends will become apparent and will have a great influence on how the doctor and others are able to provide of health care.

All doctors will know this, although they may not put it into concrete thought or word. It is probably what most of us find the most enjoyable and rewarding aspect of practice, as well as being the hardest to define. It is what I refer to in a number of places in what follows as the 'spirituality' of the consultation, in an exploration of a number of accounts of ‘embodied minds and failing bodies’.

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