Medicine is full of stories. From the dramatic, to the funny, to the action scenes, and even horror stories, a lot of narratives can be derived from the classrooms and clinics. The patients we see also have their own vivid stories to tell, and it is important for doctors to elicit these stories in order to get a clear diagnosis.
So I tried to search from google scholar while writing this article on how many journals have been produced regarding this important aspect of getting a good medical history. The result? I found one article one on history taking for medical students. Yes, one. Written in 1976!
So much for such an important skill.
So why is there a paucity of information in literature regarding history taking as a science?
Any doctor will tell you that a good patient history is often enough to formulate a hypothesis. This is why as early as the second year in medical school (and maybe even earlier), this important skill is already introduced in the medical curriculum. As a graduating medical student, one may still need to learn many things about disease management, but the most important skill that should have been mastered is the art of taking an accurate medical history.
This is how essential a story is, and medicine is full of it.
But looking at real life, how many good narratives have you read lately on the topic of medicine? Maybe you are now watching Grey’s Anatomy on Netflix, or another doctor-themed Korean series. Though the trend towards medical-themed narratives seems to be on the rise, we seem to be barely scratching the surface. It could be because of the need for data privacy, or the difficulty in understanding medical terminology.
Whatever is the case, we should not underestimate the importance of writing a good story. It also makes learning fun. A learning objective interspersed with narrative becomes more memorable. It is this creative act that may be needed to inject life into lifeless medical text. And who can resist a professor who correlates medical jargon with true to life clinical experiences?
In the assessment of a drug interaction or a side effect, the decision to investigate depends on the narrative sequence of events. Did the drug really cause it, or is it an expected outcome of an illness? The reported story and its details may spell the difference between a good, life-saving drug and one that has inherent dangers for the population.
This is also a good reason for documenting end-of-life aspects of care. A lot of patients in this stage have stories to tell – stories that we can all learn from based on experience. It is a repository of wisdom. We tend to see life as an endless tunnel. But what happens when the end of the tunnel is in sight? Are we prepared for it? One way to drift back from the light is to look back at what got you there. There is a story to every journey, and it needs to be told.
The value of a good narrative, and our appreciation for it, is what separates us humans from other animals. Even the narrative of the creation has fascinated us, promoting debate as to its authenticity and its implications. We go through life telling stories, and these foster bonds of friendship. We ask sick people about their illness, and we provide help through the information they give.
It’s time for us to enhance our appreciation for the tales we tell.
