The Principles and Practice of Narrative Medicine articulates the ideas, methods, and practices of narrative medicine. Written by the originators of the field, this book provides the authoritative starting place for any clinicians or scholars committed to learning of and eventually teaching or practicing narrative medicine.

The Principles and Practice of Narrative Medicine articulates the ideas, methods, and practices of narrative medicine. Written by the originators of the field, this book provides the authoritative starting place for any clinicians or scholars committed to learning of and eventually teaching or practicing narrative medicine.

Publisher description

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

Bridging memoir with key concepts in narratology, philosophy and history of medicine, and disability studies, this book identifies and names the phenomenon of metagnosis: the experience of learning in adulthood of a longstanding condition. It can occur when the condition has remained undetected (e.g. colorblindness) and/or when the diagnostic categories themselves have shifted (e.g. ADHD). More broadly, it can occur with unexpected revelations bearing upon selfhood, such as surprising genetic test results. Though this phenomenon has received relatively scant attention, learning of an unknown condition is often a significant and bewildering revelation, one that subverts narrative expectations and customary categories. How do we understand these revelations? In addressing this topic Danielle Spencer approaches narrative medicine as a robust research methodology comprising interdisciplinarity, narrative attentiveness, and the creation of writerly texts. Beginning with Spencer's own experience, the book explores the issues raised by metagnosis, from communicability to narrative intelligibility to different ways of seeing. Next, it traces the distinctive metagnostic narrative arc through the stages of recognition, subversion, and renegotiation, discussing this trajectory in light of a range of metagnostic experiences-from Blade Runner to real-world mid-life diagnoses. Finally, it situates metagnosis in relation to genetic revelations and the broader discourses concerning identity. Spencer proposes that better understanding metagnosis will not simply aid those directly affected, but will serve as a bellwether for how we will all navigate advancing biomedical and genomic knowledge, and how we may fruitfully interrogate the very notion of identity.

Scientific, evidence-based medicine is increasingly seen as fundamental to providing effective healthcare, but narrative-based medicine sheds light on social and interpersonal aspects of the practitioner-patient interaction which can also greatly affect healthcare outcomes. The philosophies underlying these two approaches seem to contrast, yet thos

Narrative medicine has developed an identity already. Clinicians of many disciplines are being summoned to a practice that recognizes patients by receiving their accounts of self. Starting from different positions, the four authors have converged in a strong and shared commitment to narrative health care. They conceptualize narrative health care practices within frameworks derived from the social sciences and psychology, and, to a lesser degree, phenomenology and autobiographical theory. They relate the development of narrative medicine to relationship-centered care, patient-centered care, and complex responsive process of relating theory, positing that narrative medicine can help clinicians to develop the skills required to practice relationship-centered care. The book details - with exercises, resource texts, and abundant scholarly apparatus - how these skills can be developed and strengthened. This work will change health care. Because of its scholarly rigor, its multi-voiced sources, and its highly practical features (lists, activities, key ideas and key references, primary texts written by health care professionals and patients), this work will be a guide in the field for those who practice medicine or nursing or social work. The book establishes that there is a field to be practised, a need to practise it, and a means to develop the wherewithal to do so.