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患病的心与困扰的灵:心脏疾病医师之疾病叙事的历史与叙事学研究。

Ailing Hearts and Troubled Minds: An Historical and Narratological Study on Illness Narratives by Physicians with Cardiac Disease.

机构信息

Faculty of Medicine, Department of Medical History, Lund University, Jan Waldenströms gata 15, 205 02, Malmö, Sweden.

出版信息

J Med Humanit. 2022 Mar;43(1):129-139. doi: 10.1007/s10912-020-09610-0.

Abstract

A number of studies show that when doctors become ill, there is often ambiguity in the division of roles and responsibilities in the medical encounter. Yet little is known about how the dilemma of the sick doctor has changed over time. This article explores the experience of illness among physicians by applying an historical, narratological approach to three doctor's narratives about personal cases of cardiac disease: Max Pinner's from the 1940s, Robert Seaver's from the 1980s, and John Mulligan's from 2015. Drawing on Erving Goffman's principles of social interaction, I argue that part of the challenge in the analysed narratives is because when doctors seek medical attention for themselves, the ensuing medical 'drama' suffers. I compare the three narratives to argue that the experience of becoming a patient while simultaneously remaining a doctor is a challenge that has changed over time. In Pinner's narrative, the patient identity is both undesirable and inaccessible; in Seaver's, role ambivalence between doctor and patient is the most salient feature; for Mulligan, his personal rather than professional experience of illness is the overarching theme of the narrative. Finally, I suggest that an awareness of how the medical drama often changes when doctors are patients might prove beneficial both for the doctor-patients and providers of medical care.

摘要

一些研究表明,当医生生病时,医患互动中的角色和责任常常存在模糊性。然而,人们对医生的困境随时间发生的变化知之甚少。本文通过对三位医生关于个人心脏病病例的叙述(分别来自 20 世纪 40 年代的 Max Pinner、80 年代的 Robert Seaver 和 2015 年的 John Mulligan)应用历史叙事学方法,探讨了医生的患病经历。借鉴欧文·戈夫曼的社会互动原则,我认为在分析的叙述中,部分挑战在于,当医生为自己寻求医疗关注时,随后的医疗“戏剧”会受到影响。我将这三个叙述进行比较,认为作为患者同时仍然作为医生的经历是一个随时间变化的挑战。在 Pinner 的叙述中,患者身份既不受欢迎也无法获得;在 Seaver 的叙述中,医生和患者之间的角色模糊性是最显著的特征;对于 Mulligan 来说,他的个人而非专业的患病经历是叙述的主题。最后,我建议,对医生作为患者时医疗戏剧如何经常发生变化的认识,对医生患者和医疗服务提供者都可能有益。

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