We are not human beings in medicine any more

A study of creative writing in the general practitioner consultation
Aug 2012
Patricia Ferguson, William House, Penny Nettelfield

I trained as a nurse and midwife long ago, and have published six novels and a collection of short stories. Some of my stories have also been broadcast on Radio 4. My latest book, The Midwife’s Daughter, will be out at the end of September.
Patricia Ferguson
I am now a recently retired GP and vice-chair of the British Holistic Medical Association. I have been interested in the interface of medicine and the arts for many years, and more recently ways in which the arts, action research and complexity can be used to build communities.
William House
I have worked on health-related research projects since 1995. I currently work as a practice nurse and for nine years combined that role with that of research nurse working with William House. I am particularly interested in literature and the stories we tell about ourselves and others.
Penny Nettelfield

Summary

his research was born of frustration at the loss of the quirky, colourful character that lurks within both the patient and the doctor.
By unconventionally recruiting a novelist to write word portraits, we showed the GPs how they saw their patients – opening an unfamiliar or perhaps forgotten window on their work. Revealing in a different way was the reaction of the patients to the novelist’s words about them.

First Paragraph

When the GP looks at the next patient’s electronic patient record (EPR) on her computer screen she will see one or two recent consultation notes (usually very brief), a summary of past and present medical problems, investigation results, medications, allergies and suchlike markers of health and disease. But is there no space to tell her who is this person she is about to see? Space is found for telling her whether the practice is earning the maximum revenue from this registered patient through the ‘QOF’orQualityandOutcomes Framework linking certain health and chronic illness markers to practice income. The QOF matters for health
too but what kind of portrait do they paint of the person who is about to come in? They are part of a public health agenda treating the individual as a specimen of the species and the GP as a rational economic actor. That is the implied relationship.1 Yet a deeper understanding of the nature of the unique individual’s gifts and sufferings surely becomes more vital with pressure to conform socially.2 Attempts to produce a fully comprehensive patient-centred EPR are unwieldy3 and in any case, a person is unknowable in their entirety, as expressed in poetry by MacNeice andinprosebyCassell.4,5 Giventhat knowledge will always be partial, what part could the EPR play in projecting the patient as a person? Attempts to engage patients in recording their own narratives in a personal EPR have not thrived.6 There is little published data on the recording of clinicians’ subjective impressions and narratives about their patients in the EPR.7