Kierans Ciara
Centre for Public Health, Faculty of Health and Applied Social Sciences, Liverpool, John Moores University, 70 Great Crosshall Street, L32AB, Liverpool, UK.
Cult Med Psychiatry. 2005 Sep;29(3):341-59. doi: 10.1007/s11013-005-9171-8.
Drawing on research conducted among patients in Ireland, this article examines the narrative constructions of chronic kidney failure and explores the ways in which patient narratives cross-cut and subvert modernist medical constructions of transplantation as a therapeutic outcome, an endgame, a "gift of life." In experience, patients dismantle this construction structure by emplotting their stories around the painful lack of an ending, ardently brought to bear by the lived realities of immunosuppressant drug therapy, the silent fears of graft rejection, and the isolation of recipiency. They articulate, instead, stories that disclose a multi-directional flow between past and future therapeutic interventions, between the altering nature of the renal body and personal experience. These storied dimensions are phenomenologically embedded in the sensory and temporal aspects of this condition as essential elements of chronic illness and as organizational properties of patient narratives.
本文借鉴了在爱尔兰患者中开展的研究,审视了慢性肾衰竭的叙事结构,并探究了患者叙事如何交叉和颠覆现代主义医学将移植视为一种治疗结果、一种终局、一份“生命礼物”的建构。在实际经历中,患者通过围绕痛苦的无结局状态来编排他们的故事,从而拆解了这种建构结构,这种无结局状态因免疫抑制药物治疗的现实生活、对移植排斥的默默恐惧以及接受移植后的孤立感而被强烈凸显。相反,他们讲述的故事揭示了过去与未来治疗干预之间、肾脏身体性质的改变与个人经历之间的多向流动。这些故事维度在现象学上嵌入了这种病症的感官和时间层面,是慢性病的基本要素以及患者叙事的组织特性。