a few years ago now, my head full of critical theory, i had this idea that i might do a phd in which, rather than look at some literary text, i might look at stories closer to home, the stories people tell when they come in to hospital and from there the stories that professionals tell about them to each other and back to the patient. it was to do with that notion of the creation of a patient identity that could be and might necessarily be separate from the identity of the individual.
maybe medical humanities wasn't where it's at these days or maybe it's just the faculty at my university just weren't up to speed (oh no, they said, we don't understand this..!). i could blame me but nowadays i've seen bits and bobs of that same idea pop up here and there but equally not with anything like the emphasis i wanted to put on it. the idea remains, shelved, but allowing for some intellectual rustiness on my part, still ready to go.
i still talk about it in a roundabout way whether it's teaching ecgs or reflecting on a critical method. mostly it's about questioning heuristics, their facility and application, interrogating what you 'know' if you like. these days, it being junior doctor time (tho i do the same with nurses) i torment with simple looking questions like what's on this ecg (it being sinus rhythm). sinus rhythm they'll say and then we'll go way into why it's sinus rhythm and that's where it exposes both their lack of knowledge, assumptions and errors as well as my own.
because all of us, whether we like it or not, will make a judgement based on the assumption that if a thing looks like a thing then it is a thing and that information is based on all sorts of conscious or unconscious 'knowledge'.
there's all manner of nonsense that can occur with this sort of associative thinking and even more if you don't know you're doing it. you can see it at every level of organisation in all walks of life (and esp amongst those critical theory types who are so ready to apply their theory to everything except themselves) and, i would hazard a guess, it may be more prevalent among those who assume they are 'experienced'. i would never do that they'll exclaim (for more on this in a medical context read atul gawande's book on checklists).
i'm always on the lookout for good examples of well meaning but error prone thinking and i was listening to this week's episode of this american life today when i came across a particularly tragic example (it's the second part but the first is worth a listen as a preamble). be warned, it's upsetting. all the people here were, for whatever reason, trying to 'do the right thing' and yet the consequences were far reaching. true, at the end it may be that there's some sort of rapprochement but it shouldn't be forgotten there's still a dead guy.
this american life is well worth a listen and this episode for me in particular. radio, it seems to me, is ideal for this. you have to sit, you have to listen, there is no heavily made up presenter to distract you, no commentators droning on with their opinions, no music as a backdrop to enhance 'the drama', just people's voices and time for consideration.
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