Health fiction

Author: joe

Monday, 12 November, 2007 - 18:45

I considered going to the hospital carrying a copy of 'Narrative Based Medicine' by Greenhalgh and Hurwitz. My experience has become so reflexively, regressively contingent that I thought I might as well go the whole hog, and encourage the consultants and nurses, by noticing the book, to become radically self-aware of the experience they were creating around me.

Earlier in the year I registered for my PhD, which I intend to focus on the therapeutic uses of creative activity. There is evidence that people who keep journals during their treatment for serious illnesses such as cancer have a statistically significantly improved prognosis. Why might this be? Is it the case that our experiences of serious illness are such chaotic, disempowering transactions with the machine of healthcare, that the productive act of creating our own purposeful, narrativised story out of the bare, brute facts of therapy and treatment actually improves our bodies' ability to survive?

My father was diagnosed with cancer 7 years ago and died six months later. He said the process of pin-balling between consultants and treatments was frustrating precisely because doctors want to tell you as little as possible. Perhaps for good reason. Perhaps euphemism ('growths' rather than 'tumours') helps to minimise the psychological trauma. Perhaps a gradual induction into the language of primary and secondary, benign and malignant, potassium levels, morphine and death spray is a therapeutically beneficial approach, and ignorance is convalescent bliss. Perhaps knowing little, and trusting in the authority of the medicinal apparatus improves the prognosis.

"How is your hearing?" one nurse asked him. "Pardon?" he replied.

And so, as I have had constant headaches since February of this year, which usually recede only after the self-medication of Nurofen, I have been witnessing at first hand the efficiencies of the British healthcare system. And rather like a media studies student who is suddenly noticing how adverts are constructed, I can't not examine the story of illness (or lack of narrative) the actors in my performance are creating. My consultant informed first, not me, but his dictaphone, of my almost certainly necessary surgery. What surgery, I am still only able to speculate. It is sinusitis, an infection, pus in the ethmoid. Today's MRI scan of my head was olympically efficient - I arrived 15 mins early and had left the hospital by the time my appointment was supposed to take place. I, rather unnecessarily, slowed things down by asking the nurse what happened next. "Your scans go to the consultant now, and then he will contact you soon. Just turn left out of the doors."

Of course I have the problem of Einstein's observer, watching trains travelling in different directions at the speed of light. I'm in the train, and can't get out of it to look. I can't experience medicine without thinking about the experience of medicine, and I can't think about the experience without picking out the moments that are self-selected to illustrate the competing narratives that constitute the phenomenon of medical treatment.

I also can't help but think there is a certain kind of guilt associated with querying the treatment that our noble welfare-state doctors and nurses provide. One is supposed to say "mustn't grumble...", adopt the Blitz spirit, "there are people worse off than me..", "oh it's just a touch of sinusitis..." How self-indulgent to expect a consultant to spend an extra few minutes explaining the diagnosis and how the treatment will pan out, when he must dash off to start someone's heart any second now. "Remember that the appointment that you cannot attend is very valuable to someone in pain or distress" the leaflet says. Unusual, fatal, healing, fictions.

Categories: medicine, hospital, treatment, therapy, narrative, phd,
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