ABSTRACT
Here’s the thing. Like many other academics in this country, I enjoy a comfortable middle-class lifestyle that includes having adequate health insurance, permitting access to practitioners, facilities, and medications when needed. Unlike most of my colleagues, I’ve spent the greater part of an academic career studying communication between patients and physicians. I applied the narrative paradigm, emphasizing health citizenry and patient empowerment. Having worked with clinicians for many years, on several occasions I have benefitted from privileged networks and specialized sources of information (as the following tale illustrates). So, even as I found myself in this situation-5 days before the most extensive surgery I had ever faced and totally at odds with the surgeon I had selected-I appreciated the irony of my predicament. Irony, however, definitely took a backseat to emotional upset, anxiety, and, yes, panic, as I tried to find the best way to address this problem, one that threatened my current and long-term well-being. This story illustrates how the communicative road toward patient autonomy and clinical partnership became detoured by the pain, fatigue, and stress of illness, then was blockaded by significant differences in expectations and styles between me and my doctor. It portrays how the ideal of active patient participation becomes complicated and encumbered in the actual context of serious illness and the still very powerful traditional medical model.
