Narrative Medicine and Negative Capability

Autobiographical narratives by doctors derive from several strains in recent popular culture that articulate tensions between the personal and the instrumental operating within medical culture as well. The new journalism of the sixties reinstated the first-person into a discourse that had idealized objectivity, but in doing so paradoxically refused personal engagement. Medical dramas on prime-time television personalize medicine, crystallizing the ambivalent, specular economy of the body that is the hallmark of the medical encounter. These seemingly opposed impulses are also written into the basic structures of medical education, a process of de-sensitization that has as one possible outcome a capacity, akin to Keats's "negative capability," to entertain simultaneously both genuine human emotions such as sympathy and the clinical detachment necessary to medical thinking. Rather than deny or pathologize this capacity, we need to understand it, foster it, and incorporate it explicitly into medical training.