Marshall Robert, Bleakley Alan
Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, Truro, UK.
Med Humanit. 2011 Jun;37(1):27-33. doi: 10.1136/jmh.2010.006387.
This paper progresses the original argument of Richard Ratzan that formal presentation of the medical case history follows a Homeric oral-formulaic tradition.The everyday work routines of doctors involve a ritual poetics, where the language of recounting the patient’s ‘history’ offers an explicitly aesthetic enactment or performance that can be appreciated and given meaning within the historical tradition of Homeric oral poetry and the modernist aesthetic of Minimalism. This ritual poetics shows a reliance on traditional word usages that crucially act as tools for memorisation and performance and can be linked to forms of clinical reasoning; both contain a tension between the oral and the written record, questioning the priority of the latter; and the performance of both helps to create the Janus-faced identity of the doctor as a ‘performance artist’ or ‘medical bard’ in identifying with medical culture and maintaining a positive difference from the patient as audience, offering a valid form of patient-centredness.
本文推进了理查德·拉赞的原始论点，即医学病史的正式呈现遵循荷马式口头程式传统。医生的日常工作流程涉及一种仪式诗学，在讲述患者“病史”的语言中，有一种明确的美学呈现或表演，这种呈现或表演在荷马式口头诗歌的历史传统和极简主义的现代主义美学中能够得到欣赏并获得意义。这种仪式诗学表现出对传统词汇用法的依赖，这些用法至关重要地充当了记忆和表演的工具，并且可以与临床推理形式相联系；两者都在口头记录和书面记录之间存在张力，质疑后者的优先性；而两者的表演都有助于塑造医生双面的身份，即作为“表演艺术家”或“医学吟游诗人”，认同医学文化并与作为受众的患者保持积极的差异，提供一种有效的以患者为中心的形式。
