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Professor Andrew Lees on neurology and story-telling

By Patient 39, Feb 24 2014 02:11PM

A patient’s medical history, like the plot of a film, has a beginning, a series of unfolding events and an anticipated ending. Neurologists hear new descriptions of disordered brain function every day of their working lives. It is the deconstruction of these, combined with an element of abductive reasoning, that results in accurate diagnosis.

There are certain stories that may be particularly instructive. Ray Kennedy, the former Arsenal and Liverpool football player who developed Parkinson’s disease towards the end of his career in his early thirties, taught me what it is like for an athlete to live with chronic motor handicap. He also reminded me of the importance of narrative and humility in the healing process.

Narrative-based medicine differs from a series of measurements such as blood pressure or blood sugar, and may also provide information that has no direct bearing on the unfolding events. The filmmaker instinctively knows its dramatic power and its capacity to invite interpretation. Doctors and film-makers are bound together by this dying art of story telling.

Currently there is an epidemic of neurobling in the arts with computer generated brain mapping and its pretty but indecipherable pictures at risk of providing a new generation of intellectual quackery. The story of Patient 39 is uncontaminated by modern medical technology and contains many truths that neuroscience is in no position to trump. It is often said that doctors need their patients more than patients need their doctors and the beauty that Dr Moran glimpses through his care of Patient 39 may be one reason why.

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