Abstract
In Reply.— I thank Dr Graner for the opportunity to clarify the matters raised in his letter. First, I did not say (nor did I wish to imply) that in the past physicians' narratives of illness paid much attention to what the patient knew and felt about the illness. What physicians often did, for its diagnostic value, was to construct a finely detailed account of the subjective experience of sickness (ie, the development and course of symptoms) in a particular individual. The result may have been closer to a story of a disease in a person than to a story about a person. But it was in its own way a story, since the narrative accessed both subjective and objective realities. The need for diagnostically convincing narratives has now, to some extent, declined because of advances in laboratory diagnosis. Consequently, even straightforwardly somatic symptoms tend to get short shrift in
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