ABSTRACT
It was common, but not universally practiced, to re-demonstrate the computed tomography (CT) scan review with the patient as a method of explaining the diagnosis. The interpreter was pointing at the computer screen, comparing the normal kidney to the one with the abnormal mass. The next vignette occurred in an inpatient setting. The urologist could not take the computer into the patient's room, so he printed an image from the CT scan and took it with him to pronounce the diagnosis. The patient has to be convinced the diagnosis is correct and agree to the treatment. The diagnosis narrative is only effective if the patient can recognize the diagnosis story as the story of the disease affecting themselves. Achieving joint attention between the doctor and the patient to the diagnostic narrative is a key component of the clinical encounter because it is necessary to move from diagnosis to therapy or treatment.
