Dr. Margaret Kay MBBS(Hons),FRACGP, Dip.RACOG The University of Queensland TRANSFORMATIVE NARRATIVES...
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Transcript of Dr. Margaret Kay MBBS(Hons),FRACGP, Dip.RACOG The University of Queensland TRANSFORMATIVE NARRATIVES...
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Dr. Margaret KayMBBS(Hons),FRACGP, Dip.RACOG
The University of Queensland
TRANSFORMATIVE NARRATIVES
IN DOCTORS’ HEALTH: POSITIVE
REPRESENTATIONS OF THE
WOUNDED HEALER
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Defining narratives
• “ method of recapitulating past experience by matching a verbal sequence of clauses to the sequence of events that actually occurred”
(Labov)
• constructed• orientation, complication, evaluation, resolution (coda)
•Stories are dialogic • Bakhtin - Co-construction
troublewhere/when unfolding sorted out
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Wounded Healer• Ancient mythology
• Chiron• Teacher /Healer– Asklepios• Arrow wound – poison of the hydra
• Jungian – analytical psychology – archetypal images• Mental health
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Narratives included:
• Authored by the doctor with the illness• Published in a medical journal• Or anthology of ‘articles’ on doctors’ health• Excluded – memoire/biographies for lay community• 160 narratives (>250)• Saturation
MedlineCinahlPsychinfoGrey literatureAnthologies
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•Typologies - Arthur Frank
• Restitution • being sick getting treatment and being
healed
• Chaos• no meaningful response to illness
• Quest• ill person finds meaning in illness, • works with illness• move forward in life
Illness Narratives
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Themes
“aversion to the hospital that embodies the "faustian soul of modern technology".”
"I have lived most of my life with the certainty
that a "big illness" was waiting for me. Not an
ordinary illness, but something obscure...”
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Themes
•Becoming a patient
•Care received
•Effect of the illness
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Becoming a patient•Crossing the ‘thin red line’ • Crossing the border, ‘changing hats’
•Want to be a normal patient / a good patient
“Although I had passed the examinations put out by the American Board of
Internal Medicine, she [the patient in the next bed
with [Hodgkin's disease] seemed to know a lot more about being sick and being
a patient than I did...”
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Care received•Disappointment•Changed doctor / Self-treatment
•Shared-decision making•Need for hope•Rapport /empathy / trust
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Effect of illness•Blow to omnipotence
•Altered outlook on life• Positive work-life balance
•Altered outlook on medical practice• Better doctor• Value the art
“Suffering had
sensitized me to
the human
condition.”
“I am sure my illness has made me a better physician”
“given me confidence that caring and
encouragement can go a long way in
helping”
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Narratives guide to our listeningorientation, complication, evaluation, resolution (coda)
• Content • Construction • How it is told – the emplotment• Association, Causation• Meaning
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Narratives guide to our listening • Professional stories – Restitution• being sick, getting treatment, and being healed
• Chaos – Avoid
• Personal stories – Quest• Healing lies in finding the meaning
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Transformation •We can choose our narrative
•Reflection – enables the writing of the narrative
•Chaos can be transformed
•Assist through Co-construction • rapport / trust / relationship• enables shared-decision making• allows the patient to be a good patient
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Transformation •We can choose our narrative
•Reflection – enables the writing of the narrative
•Chaos can be transformed
•Assist through Co-construction • rapport / trust / relationship• enables shared-decision making• allows the patient to be a good patient
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Transformation •We can choose our narrative
•Reflection – enables the writing of the narrative
•Chaos can be transformed
•Assist through Co-construction • rapport / trust / relationship• enables shared-decision making• allows the patient to be a good patient
![Page 16: Dr. Margaret Kay MBBS(Hons),FRACGP, Dip.RACOG The University of Queensland TRANSFORMATIVE NARRATIVES IN DOCTORS’ HEALTH: POSITIVE REPRESENTATIONS OF THE.](https://reader037.fdocuments.net/reader037/viewer/2022110116/551bea60550346af588b634a/html5/thumbnails/16.jpg)
Transformation •We can choose our narrative
•Reflection – enables the writing of the narrative
•Chaos can be transformed
•Assist through Co-construction • Treating-doctor / Doctor-patient• rapport / trust / relationship• Patient-centred medicine