Narrative and Medicine Project – Brian Hurwitz

WHAT SORT OF A NARRATIVE IS A CLINICAL CASE REPORT?
Brian Hurwitz

Date: December 15, 2011 | 17h00
Venue: Centro de Saúde de Sete Rios, Lisbon
Organization: ULICES / CFL / CHL / CBAS

At the heart of medical practice lies a discursive formulation which problematises and fathoms something important about an individual. The clinical case report arises from consultations and offers an exemplary account of clinical thinking about a sick person’s medical situation to a distant audience who will never see, hear from or meet that patient. Does the notion of a case precede that of case report or is apprehension and classification of cases so bound up with discussing and comparing word pictures that case and case report can be collapsed together as one and the same thing?

Clinical case reports are presentational and communicational discourses that place before an audience a linguistic portrait of sorts; such portraits require to be composed not only of descriptive, observational elements (including those offered by patients themselves) that include recognisable elements of the person consulting, but also need to contain taxonomic reference to what demands explanation in physiological and pathological terms. Hence, in composing a case report the physician-narrator’s attention roves from focus upon a person to focus upon a body or psyche; from attention to a body to examination of body-part, bio-system and towards looking at physiological and pathological processes.

On one account, the clinical case report can be viewed as a type of narrative – a ‘usable story’ concerning an episode or occurrence in a person’s life composed from a distinctive medical point of view subsisting in relation to other writing practices which focus on fathomability . On another account, the case report can be understood to access and represent – in part to construct – a virtual model of phenomena under scrutiny, a model variously consisting of body parts, pathological mechanisms and psychological processes, assembled clinically from testimony, observation, examination, scanning and measurement. Hence it is that the modern case report is recounted not only in words, but also in formulae, numbers, tracings and images and assumes a form as reminiscent of a scientific report as of a narrative.

Brian Hurwitz is a medical practitioner and Director of the Centre for Humanities and Health, at King’s College London. His research interests encompass narrative and clinical medicine studies, ethics, law, and the dialogue between the several disciplines of the arts, the humanities and medicine. He is a member of the editorial boards of the scientific publications: Journal of Evaluation in Clinical Practice, Chronic Illness and Clinical Medicine. He has authored several essays on narrative and clinical practice issues, and published the books: Narrative-Based Medicine: Dialogue and Discourse in Clinical Practice (1998), Narrative Research in Health and Illness (2004) and Health Care Errors and Patient Safety (2009).

The Narrative and Medicine project seeks to explore the relationships between Medicine and the Humanities, in the context of the therapeutic relationships with the patients, through an interdisciplinary research group of scholars from the Centre of English Studies and the Centre of Philosophy of the University of Lisbon, the Centre of Cultural History of the New University of Lisbon and the Abel Salazar Institute of Biomedical Sciences. The 2011 Conference Programme aims to contribute to the training of health professionals and of researchers in the Humanities. Well-reputed specialists, responsible for the implementation of similar programmes in Europe and the United States, as well as pioneers in this area on a national level, will cooperate with the North-Lisbon Healthcare Centres. Its head office, at Sete-Rios Healthcare Centre, in Lisbon, will host the (open access) conferences, from March to December 2011.

Participants may acquire a briefcase containing related texts (15€), as well as a certificate of presence (5€ per session).

For the annual programme and for further information, please consult
– our website http://narrativeandmedicine.blogspot.com
– or send an e-mail to narrativaemedicina.flul@sapo.pt