Every illness is a story

In What seems to be the trouble? Trisha Greenhalgh, Professor of Primary Care at University College London, takes a narrative approach to narrative. A story, she says, can explain an illness, help to diagnose an illness, illuminate the dark corners of a complex illness and generate new meaning, or help to shape an illness.

Her book is not just about individuals. There are stories about systems, too. A chapter on “Stories and organisations” begins with a comment in a hospital visitors’ book. After describing the delays in treatment for his dying father, the writer said, “I am shocked and amazed that you consider the management of my father’s case and the administration of his treatment to be of a good standard”. In the same chapter, a consultant obstetrician tells the story of a teenage girl who froze to death in the grounds of a hospital after being discharged late in the afternoon, following a miscarriage, “Apparently no one — or at least no one on duty at the time — had known that this unfortunate young woman did not have a home to go back to”. The obstetrician was one of a group of health professionals who were opposing an attempt by the National Institute for Clinical Excellence to delete such stories and adopt a more evidence-based approach in their report writing. Facts and figures, the group agreed, are not enough — stories have emotional traction, and emotions drive change.

A chapter on “Stories and research” provides a small dose of narrative theory and some narrative research methods. It’s a bit unnerving to see J K Rowling (author of the Harry Potter childrens’ books) on the same page as Martha Nussbaum (the American philosopher), or to skip from Aristotle to Derrida and Foucault in a book of fewer than 100 pages, but the author has the deft touch of a skilled raconteur. In these and the other chapters on illness, healing, learning and ethics, medical readers will gain practical insights and a better understanding of the narrative approach.