April 17, 2021

Series introduction: narrative language in medicine


Narrative language is everywhere in medicine. How does this influence how we think & document patient information?

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The upcoming posts will explore how narrative language is everywhere in clinical medicine. I want to look at how it improves and hinders medical documentation, influences the ability to diagnosis correctly, and the challenges we face in incorporating narrative structure into the visual data of quantitative data.

Humans naturally like narratives, so it comes as no surprise that we think, record, and present patient's cases as narrative stories in medicine.

What exactly is a narrative? It may be a fictional or non-fictional story, but in either case, it includes the common elements of a time, a place, characters, and a plot development. The plot unfolds typically with a beginning, middle, and end.

Humans enjoy both listening to and telling narratives. The human brain, it seems, is aptly tuned to listen along to a narrative while carefully storing away the key details for easy retrieval and concurrently anticipating the next steps in the plot. Narrative language starts when we are young, and a critical domain that young children are examined on is their ability to understand and retell narratives.

In clinical medicine, we continuously encounter narratives: patients tell physicians narrative stories about their health. We then try to summarize their stories in our own words as a narrative. We communicate to our colleagues, particularly in verbal communication, through narrative stories.

The narrative language structure is so prevalent in medicine that it is hard to imagine its absence. In some of the upcoming posts, we will explore the benefits and drawbacks of narrative language in clinical medicine. In what ways does narrative language lead us astray to make the wrong diagnosis at times? And in particular, understand how we can incorporate narrative language in the visual display of quantitative information?

As we'll see in a few articles from here, the absence of narrative language in modern electronic health records is thought to be breeding a generation of physicians who lack certain diagnostic reasoning and communicating skills. Furthermore, electronic health records use sterile data presentations that impair clinical reasoning and patient care.

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