Friday, June 30, 2006

Narrative Medicine

Anyone who has ever been sick has a story. People who get an illness, a disease, an ailment, seem to be more willing to discuss their experiences of unexpected results or terrible side effects, tragedy or success, and medical journalists are trying to figure out the best way to weave together the science with those stories.

“80 percent of illness can be diagnosed based on a patient’s story,” said Sandeep Jauhar at a panel discussion hosted by the Association of Health Care Journalists this week. A cardiologist and freelance writer, he and many medical journalists are taking those stories and writing them in the style of “new journalism.”

Medical journalists continue the debate about how those narratives should be incorporated into scientific stories.

A good medical story should have all the qualities of any other good story. It should be both interesting and informative and often the best way to pair those qualities is through people’s personal experiences. Readers are interested in hearing about illnesses that affect them. “You don’t have to sell people real hard on being mortal,” said Henry Finder, the editorial director of the New Yorker magazine, at the panel discussion.

In Finder’s opinion, a good story must have an A plot, the foreground of the story, and a B plot, what it means, which can both be explained with narratives. The smaller narratives are wrapped around the primary narrative of the story he said, like cutouts from the main picture. “Every piece you write is going to be, if it’s interesting, tangential,” he said.

But anecdotes are not always just about the patients, they are also about the writers. Paul Raeburn, a contributor to the New York Times Magazine, wrote a book called Acquainted with the Night, which is about his children who both have mental illnesses. “You want to step out of that wallowing in your own story,” said Raeburn at the panel, and share experiences with disease, even as the writer.

Other medical journalists don’t want to rely on the narrative. “I don’t want to write about my mother’s Alzheimer’s,” said a woman in the audience. She would rather stick with what science shows.

Every story is different, and different approaches can be equally effective, but as far as the narrative is concerned, medical journalism, like most other forms of journalism, continues to evolve and find its footing.