We citeren een stuk uit 2008 van een hoogleraar interne geneeskunde uit New York, die speciale aandacht heeft voor de narrative medicine: 

At the same time that interest soars in the evidence-based “right” decisions—an interest that privileges the known/knowable, the universal, and the body—we see a growth in medicine's interest in the unknown/unknowable, the particular, and the self—in patients' lived experience, illness narratives, and the interior lives of clinicians.

For years now, the fields of narrative medicine and literature and medicine have reminded doctors that illness unfolds in stories, that clinical practice transpires in the intimacy between teller and listener, and that physicians are as much witnesses to patients' suffering as they are fixers of their broken parts. More and more clinicians and trainees are being encouraged to write about their clinical practices so as to develop the capacity for reflection. New clinical routines that provide patients with copies of what their doctors write about them or that encourage patients to contribute directly to their medical records are challenging traditional notions of authorship of the clinical record and, indeed, of the illness.

Forms of medical interviewing that resemble ethnographic field work or psychoanalytic listening rather than bureaucratic check-listing are on the rise. Whether they call their enterprise patient-centred care, mindful practice, relationship-centred care, or narrative medicine, many clinicians and patients are converging in a federation that proposes recognition of singularity, respect for illness's mystery, and attention to the embodied self as the fundamentals of health care.

Some authors have addressed the need to resolve the potential conflict between the objectivity of EBM and the narrative singularity of both patients' and clinicians' lived experience. They have considered “narrative-based medicine” as a possible remedial avenue.

Building on their work, but trying to avoid the implied opposition (must one choose between “narrative-based” and “evidence-based”?), a group of clinicians and scholars at Columbia University has undertaken a programme that explicitly integrates these realms and tries to illuminate fundamental unities between them. Calling the effort “narrative evidence based medicine” (NEBM), our project recognises the narrative features of all data and the evidentiary status of all clinical text. The skilled clinician does not first collect and deploy evidence and then soften it up with narrative; rather he or she is always already embarked on grounded, rigorous, personal, particular, and perilous interpretations that, like any hypotheses, can be tested for trustworthiness and utility.

Dus eindelijk een herziening van het belang van het patienten verhaal. Goed te weten. Kennen we niet allemaal die opmerking: Ohh dat is alleen maar een patienten verhaal.... 

Bron

Perspectives: Narrative evidence based medicine Lancet Volume 371, Issue 9609, 26 January 2008-1 February 2008, Pages 296-297.

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