Steensma David P
From the Dana-Farber Cancer Institute, Boston, MA.
Am Soc Clin Oncol Educ Book. 2013. doi: 10.1200/EdBook_AM.2013.33.e331.
Storytelling is a deeply human act-ancient, universal, and familiar. But in this data-driven "Information Age," is there still room for narrative? As oncologists, we often feel overclocked, increasingly forced to microtask and live by the business world's mantra of "faster, cheaper, better," while our carefully honed humanistic clinical skills are coldly commoditized into Relative Value Units, our aptitude measured with tools that emphasize form over substance. In such an environment, can we still afford the inefficiency of anecdotes? Some might argue that we no longer need patient and physician narratives to inform care; instead, accurate molecular subtyping of tumors, good pharmaceutical agents, and rigorous clinical trial results are enough. Yet stories and reflections about being a doctor or being a patient remain important and instructive even in this era of molecular cancer medicine, even in the face of our increasing reliance on high-tech diagnostics and narrowly targeted smart therapeutics. Amid the pressures of rapidly changing practice patterns and the daily emotional challenges of working with seriously ill and dying patients, the acts of reflection and storytelling can also help keep us sane. Here I discuss the persistent importance of narrative in the context of the "Art of Oncology" forum of the Journal of Clinical Oncology.
讲故事是一种极具人性的行为——古老、普遍且为人熟知。但在这个由数据驱动的“信息时代”，叙事还有空间吗？作为肿瘤学家，我们常常感到压力过大，越来越被迫进行微任务操作，并遵循商业世界“更快、更便宜、更好”的准则，而我们精心磨练的人文临床技能却被冷酷地商品化，成为相对价值单位，我们的能力用那些重形式轻实质的工具来衡量。在这样的环境下，我们还能承受轶事带来的低效吗？有些人可能会说，我们不再需要患者和医生的叙事来指导治疗；相反，肿瘤的准确分子分型、优质的药物以及严谨的临床试验结果就足够了。然而，即使在分子癌症医学时代，即使面对我们越来越依赖高科技诊断和精准靶向智能疗法的情况，关于成为一名医生或患者的故事和思考仍然很重要且具有启发性。在快速变化的实践模式的压力以及与重症和临终患者打交道的日常情感挑战中，反思和讲故事的行为也有助于我们保持理智。在此，我将在《临床肿瘤学杂志》的“肿瘤学艺术”论坛背景下讨论叙事的持久重要性。
