“Medicine tells us as much about the meaningful performance of healing, suffering, and dying
as chemical analysis tells us about the aesthetic value of pottery.”

Ivan Illich

Meaning in Healthcare

There has been much focus on ‘Evidence Based Medicine’ in recent years sometimes at the expense of seeing the patient as a person and of hearing their ‘story’. However to best help our patients we need both. This is not a new debate (see the Narrative Based Medicine series from 1999 by Trish Greenhalgh in the BMJ).

In the TED talk below Dr Rita Charon asks “What might medicine be for?”

Also by Dr Charon Narrative evidence based medicine, Rita Charon & Peter Wyer, The Lancet, Jan 2008

“We work in the dark—we do what we can—we give what we have. Our doubt is our passion and our passion is our task. The rest is the madness of art.”

Henry James, The Middle Years

For more on Narrative Based Medicine see our ‘Discover’ page


The knitted glove

You come into my office wearing a blue
Knitted glove with a ribbon at the wrist.
You remove the glove slowly, painfully
And dump out the contents, a worthless hand.
What a specimen! It looks much like a regular hand,
Warm, pliable, soft. You can move the fingers.

 If it’s not one thing, it’s another.
Last month the fire in your hips had you down,
Or up mincing across the room with a cane.
When I ask about the hips today, you pass them off,
So I can’t tell if only your pain
Or the memory is gone. You knitted hand
Is the long and short of it. Pain doesn’t exist
In the past any more than this morning does.

 This thing, the name for your solitary days,
For the hips, the hand, for the walk of your eyes
Away from mind, this thing is coyote, the trickster.
I want to take it by its neck between my hands.
But in this world I don’t know how to find
The bastard, so we sit. We talk about the pain.

Jack Coulehan