Eva's stories: recognizing the poverty of the medical case history.

Abstract

The medical case history is a proven tool for approaching the question "What is wrong with this person?" Its virtues, however, can become vices, in part as a consequence of the dehumanizing flight from sensitive subjectivity to sanitized objectivity, from human interest to "science." The case history, because it is so useful and effective, is not likely to be profoundly altered in the future, but medical educators can make themselves and their students more aware of the serious flaw in this form of discourse, i.e., the erasure of the unique individual from his or her disease. The exercise of asking medical students to abstract case histories from richly written short stories, novels, plays, or operas might heighten students' recognition of the poverty of the medical case history. To illustrate this idea, the story of Eva, a dying woman, is presented initially as a typical medical case history; it is then contrasted with excerpts from a novelist's narrative of Eva's life.