Literature about medicine may be all that can save us

A new generation of doctor writers is investigating the mysteries of the medical profession, exploring the vital intersection between science and art

The language gap frustrates your visit to your doctor. He seems not to understand the problem because you can’t describe it lucidly enough. You don’t understand the proposed treatment because he can’t explain it. I’ve sometimes foresworn medical help because the complexity of voicirng what is wrong has felt heavier than the sickness itself. This is especially true for psychiatric illnesses such as the depression I have experienced, but it is true of physical problems, too. It has been entirely manifest to me when I’ve tried to explain the problem with my left ear, in which I am partially deaf. I’ve said what it feels like, to which my consultant has repeatedly replied with various options. I’ve said it doesn’t feel like any of the things in his multiple-choice list and theorised about what is actually wrong. He has resisted my inexpert opinions, and I have battled with his inability to grasp the subtlety of my experience. We are both articulate and we are both exasperated by this sticky communication.

Language is integral to medicine. It is hard to cure a condition you cannot describe, and few treatments for those conditions go without names of their own. Even veterinarians, trained to diagnose animals who cannot put their complaints into words, begin by labelling the illness and proceed by specifying the treatment. The emerging field of narrative medicine proposes that patients can be treated correctly only when they can tell the story of their illness, often in the context of a more extensive autobiography. A doctor usually begins by getting the patient to describe their pain, and often arrives at diagnosis as much through that interaction as through anything he can observe. Illness is temporal, and language helps to chart its course, even when x-rays, MRIs, CAT scans and other images can represent its current state. A picture is not always worth a thousand words; sometimes, it is the words that tag the problem. You tell the doctor how you felt yesterday and how you feel today; the doctor tells you how you should feel tomorrow. That interaction is part of the cure; it is why a physician’s bedside manner can have such an enormous impact on his efficacy. We are embodied, but our minds order the brokenness around us by imposing vocabulary on it. In fact, there is some evidence that people who can speak more fluently receive better medical care; patients deprived of language are often subject to abuse.

Continue reading...