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A Piece of My Mind
July 23/30, 2014

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Author Affiliations
  • 1Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, Massachusetts
  • 2Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee
JAMA. 2014;312(4):345-346. doi:10.1001/jama.2014.6201

The ill body is certainly not mute—it speaks directly in pains and symptoms—but it is inarticulate. We must speak for the body ... 1

Narrative medicine has been an evolving topic bridging anthropology, literature, and science for many years. Patient narratives are a source of knowledge and insight as they provide physicians with information as medically relevant as numerical data about pulse and respiration.2 Likewise, narrative theory has been increasingly used within medical humanities as a means of emphasizing the subjective experience of illness by promoting narrative competence.35 A patient’s autopathography—the patient’s own illness story—is the root of medicine; as most diagnoses in primary care result from history alone, the anamnesis (the account the physician assembles from the patient’s history) is crucial.5 As pressures on our health care system shift the emerging practitioner’s focus from the individual patient to high-volume throughput, it is increasingly incumbent on the clinician-teacher to emphasize the importance of each patient’s personal narrative for constructing both a complete history and a targeted treatment plan. The less acknowledged aspect of a patient narrative is its use for teaching about a disease, for creating empathy in a student, for inspiring other patients and, in the process, empowering them, for making them feel valued.

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