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January 23/30, 2002

Patients' Stories as Narrative

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(4):447-448. doi:10.1001/jama.287.4.447

To the Editor: I agree with Dr Charon1 that "the effective practice of medicine requires narrative competence, that is, the ability to acknowledge, interpret, and act on the stories and plights of others." I also agree that reading fiction and memoirs that insightfully relate experiences of doctoring and illness can help students and practitioners of medicine better comprehend both their own and their patients' experiences. However, her wide-ranging article about narrative medicine says nothing about the narratives that are at the core of the learning and practicing of clinical medicine: the case histories that students, residents, and attending physicians compose, present, and record every day in teaching hospitals. For most of the past century or so, these narratives have focused primarily, even exclusively, on the manifestations, diagnosis, treatment, and course of biological disorder. The person and perspective of the patient were addressed (if at all) informally and off the record.