BETH 410 Week 8 Response 7

Saagar Pamulapati
When analyzing narratives, Mattingly and Garro state that we need to analyze what is
useful and what is not in narrative theorizing (5). The latter part of this statement, what is not,
is what I kept coming back to when doing the readings for this week. Not to be crass, but I just
felt like there were not enough concrete examples of how narratives are important in clinical
situations. Mattingly and Garro state that critical voices are essential, and I will happily take
on that mantle for the remainder of this response (6).
The reason I was unconvinced was that Mattingly and Garro do not establish many
situations where narratives are important. They state the obviousness of why it is important for
psychiatry, and then claim that there are other professions where narrative is significant (8). They
make sweeping claims about bringing it back to subjective experience, but do not provide
convincing examples for how that storytelling is useful in other medical professions. Even their
statements about Alcoholic Anonymous meetings, and the effect of narratives on those meetings,
is about a therapeutic conversation (26). I just thought this resembled psychiatry too much and
doesnt confirm the importance of narratives in an entirely different way or context.
The summaries of future chapters also highlight how analyzing narratives can be
problematic (33-35). Perhaps that is one of the points Mattingly and Garro are trying to make,
but I think it undermines a lot of the claims they make in the introduction about the
characteristics of stories and their significance to illness. I just did not see the point in describing
stories to such an extent if the rest of the book deals with critiquing their practical use. Mattingly
and Garro state that stories should allow for personal meaning; a so what? as they describe (3).
I actually kept asking that question when going through the readings for this week. I understood
the various qualities of stories being described, but so what? I did not see how this all concretely
related back to clinical situations.
I found the characteristics and description of stories at the beginning also problematic and
over assuming. Mattingly and Garro state that stories can show what is dangerous and worth
taking risks for (11). They support this statement by further adding that stories should convey
the extraordinary. They believe stories should stay away from the mundane or how life is
routinely lived (11). I actually think this is too extreme and falls through when one considers a
physicians daily duties. When explaining procedures and risks to a patient, I think most

physicians actually want to convey that certain procedures are part of their daily routine.
Rather than exciting stories, through my personal experience while shadowing and volunteering
in the hospital, I have witnessed physicians calmly telling numerous stories about past patients
where a procedure has worked over and over again.
In this case you can see how a story is used to promote a sense of everyday behavior
rather than meant to elicit risk taking behavior. In addition, Mattingly and Garro state that
emotional elaboration helps stories be more believable (30). I think my earlier reasoning
disproves this statement as well. A physician should definitely be careful when emotionally
elaborating or infusing his own feelings into a discourse with a patient. I can see exaggeration
being very dangerous in such doctor-patient interactions and relationships. Giving patients a false
sense of security can be justified in certain situations, but that should be rare and never taken to a
certain extent. The opposite, a scientific impartiality, can often be very convincing and
believable.
Even the Charon reading, which I guess was supposed to illustrate the significance of
illness without skepticism, had some issues. Out of three medically certified personnel Charon
states she will later draw from, once again one of them is a psychiatrist. I cannot help but wonder
if narratives actually dont play a huge role in other physicians professions. To change my
viewpoint, I would be very interested in reading more of the Charon book on how the other two
personnel, the general physician and pediatrician, view narratives (x).
That being said, the main point from both the Charon reading and Mattingly and Garro
reading that I agreed with was the assertion of how important narratives are for self-identity and
individual perception of illness. Mattingly and Garro state that narratives allow for selfreflection and reorientation (34). They argue that narratives help makes an inexplicable and
uncontrollable disease become defined and coherent (7). Charon echoes this argument
throughout her entire introduction; specifically, when she states narratives can be a relational
source of identity which emphasizes languages unique power to define, describe, and expose
what human being see and can know (x). Both of the readings demonstrate convincingly that
narratives are very important for subjective experience and ones individual, unique perception
of your own illness,
The reason this seems very plausible and realistic, especially when considering actual
clinical situations, is that I see the obvious benefit from an individual talking about his disease

and not considering it a debilitating weakness or something that is taboo. Garro and Mattingly
emphasize this when they state telling ones story is a crucial part of the healing process (7).
They go so far as to claim stories are a Rosetta Stone for explaining subjective experience (7).
Now it must be asked, what is the importance of physicians understanding their patients
subjective experiences? I think increased understanding engenders empathy and better
knowledge of how to proceed with treatment. Mattingly and Garro state that stories can reshape
the past through different recollections, but most importantly stories can open up new doors in
the future (7). Once a physician understands his patient and how that patient is suffering, he can
choose different procedures or treatments based on that narrative the patient tells him. He can
start to see the right doors for the individual patient.
In addition, a patients interpretation of their experience gives specific knowledge about
that individual. Mattingly and Garro state that an outsider can better appreciate an individual just
by looking at how an individual reacts to or delivers a story (3). On the flip side, that same
process can be done on the side of the patient. The patient can observe how the physician is
reacting to or delivering a story in order to better understand his point of view. Hopefully,
through this interaction both individuals can breach what Mattingly and Garro call the landscape
of consciousness (2). Mattingly and Garro describe that concept as a glimpse into why people in
stories are acting a certain way and what they are thinking during that action. I propose that there
is a landscape of consciousness even in everyday interactions outside of stories. Trying to
understand a persons thought process in interactions between patients and doctor can make sure
both people are approaching the issue together and in the same way.
This dual appreciation for each other is a cornerstone of modern medicine. Both the
Affordable Care Act, which stresses increased social engagement with patients, and new
revisions to the MCAT, with new sections in sociology and psychology, demonstrate that
America is moving towards a more social appreciate for health and clinical outcomes. Even
while completing my medical school application, a phrase that was used over and over again was
patient-centered care. Many medical schools are looking for applicants that can treat the
patient as the locus. To accomplish that, one must try to understand the patients subjective
experience. We should be treating patients as unique individuals rather than a set of symptoms
which could well signify a lab rat (Mattingly and Garro, 2).