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2017 ; 62
(ä): 65-73
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Narrative constructs in modern clinical case reporting
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Hurwitz B
Stud Hist Philos Sci
2017[Apr]; 62
(ä): 65-73
PMID28583361
show ga
Modern clinical case reporting takes the form of problem-solution narratives that
redescribe symptoms in terms of disease categories. Authored almost always by
those who have played a part in the medical assessment of the patient, reports
historicise the salient details of an individual's illness as a complex effect of
identifiable antecedent causes. Candidate hypotheses linking illness to
pathological mechanisms are suggested by the patient's experience, and by data
that emerge from clinical examination and investigation. Observational and
interpretive statements from these considerations are fitted into a temporally
inflected account of the patient's medical condition, configured from the vantage
point of hindsight. Drawing on established forms of deferred telling, readers are
invited to follow a story that drip-feeds a mixture of contingent and
non-incidental information into the account, which engenders and frustrates
curiosity, creates expectations, and challenges powers of reasoning and pattern
recognition. Whereas case reporting once favoured memoir, the sentimental tale
and eccentric biography as the means by which its historical narrative was cast,
the preferred genres of contemporary case reporting include detective fiction,
and puzzle and riddle narratives, formats that conceptualise the medical
consultation in narrow problem-solution terms.