ABSTRACT
In the rise to dominance of narrative-based medicine, we may forget that where medicine happens (place and space) is as important as the how and when of illness as an unfolding story. One result of narrative medicine’s dominance has been to displace interest in lyrical poetry where the focus is on space rather than time. Poetry is a highly metaphor-rich compacted experience bounded by space. A doctor may take a “history” but patients present symptoms in a less logical and more compacted fashion, often without plot. Can we see the doctor-patient encounter in terms of poetics, as a metaphor-rich and imaginative experience, and of what value is this? Where literary theory emphasises the value of “close reading” of a text, can we treat patients as texts with an emphasis upon close noticing as the basis to diagnostic acumen? Here, what is presented semiotically – as signs and symbols, including the non-verbal – is as important to diagnostic expertise and to forming a doctor-patient collaboration as the verbal story. What does the avant-garde of clinical practice look like, and can we practice a lyrical medicine?
