A BRIEF TAKE ON GENETIC SCREENING
DOES MEDICINE INCREASE A PATIENTS ABILITY TO WRITE HER OWN LIFE?
by Richard Powers
HISTORY OF CURRENT COMPLAINT:
A forty-seven-year-old white male, 6' 4", 165 pounds, new to this service, presents with chronic belief that medicine and narrative are inextricably linked. Patient has no history of delusional disorder and claims to be on no present medication.
And then what happened?
From the earliest campfire fable, this question has united hearers and tellers, doctors and patients, readers and writers. And from the earliest diagnostic chart, our need to know What happens next? has slammed up against that classic source of dramatic tension: knowing whats coming does not shield us from living it.
We humans remember in story, anticipate in story, dream, explain, learn, and love in story. As patients, we grow ill and recover, rally and fade, all experienced as narrative excursions inside wider story frames. So it hardly diminishes the rigorous, empirical, and context-free nature of medical diagnostics to say that medical practice is a narrative art. From taking the history and physical to signing off on the postmortem notes, doctors read, and then help arrange, relevant clinical data into a series of causes and effects that forms a linear, time-driven story. Diagnosis and treatment are sometimes a detective novel, sometimes a domestic drama, sometimes a good old psychological character sketch.
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