Playing doctor well

Abstract

Most neurologists will say they are all for good bedside manners. In practice, though, the word “manners” makes many of us uncomfortable. Manners sound tricky and artificial, like the rules about which fork to use, or how to be polite to people you dislike. One solution has been to talk instead of empathy. For the practitioner, empathy feels more real than playing doctor. Empathy seems a solid motive force for compassionate and nuanced communication with patients. In this issue of Neurology ®, Alcauskas and Charon present an approach to fostering such communication that uses literary techniques when thinking and writing about patients.1 They argue that narrative competence in medicine, the ability to interpret and tell stories about and to patients, is particularly important for neurologists. In neurology, patients’ histories are often the key to diagnosing and understanding their illnesses, and yet these histories are often hindered by impaired ability to speak. Charon has founded the successful and prominent Program in Narrative Medicine at Columbia University. It offers workshops for physicians, as well as courses for medical students. But the two …