Farkas Carol-Ann
School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston, MA 02130, USA.
J Med Humanit. 2013 Sep;34(3):315-28. doi: 10.1007/s10912-013-9234-8.
Illness narrative has often been found to play a positive role in both patients' and providers' efforts to find meaning in the illness experience. However, illness narrative can sometimes become counterproductive, even pathological, particularly in cases of medical mystery--cases wherein biopsychosocial factors blur the distinction between bodily dysfunction and somatizing behavior. In this article, the author draws attention to two examples of medical mystery, the clinical presentation of medically unexplained symptoms, and the popular reality television program Mystery Diagnosis, to demonstrate the potentially harmful effects of illness narrative. The medical mystery's complex narrative structure reflects and tends to reinforce providers' and patients' mistaken assumptions, anxieties, and conflicts in ways which obstruct, rather than facilitate, healing.
疾病叙事常常被发现对患者和医疗服务提供者在疾病经历中寻找意义的努力起到积极作用。然而，疾病叙事有时可能会适得其反，甚至成为病态，特别是在医学谜团的案例中——在这些案例中，生物心理社会因素模糊了身体功能障碍和躯体化行为之间的区别。在本文中，作者提请注意两个医学谜团的例子、医学上无法解释的症状的临床表现以及热门真人秀节目《神秘诊断》，以证明疾病叙事可能产生的有害影响。医学谜团复杂的叙事结构反映并倾向于强化医疗服务提供者和患者的错误假设、焦虑和冲突，其方式阻碍而非促进康复。
