Voice of Illness and Voice of Medcine in Doctor-Patient Interaction
The role of doctors and patients become pivotal in medical care as the transformation of lay category (illness) to a medical category (disease) is facilitated through their interaction. The present paper examines the interaction between doctors and patients in the process of fever care rendered by the allopathic hospitals of Kerala, India. Narrative analysis will be used as it can simultaneously be a tool to situate the physician and patient in their socio-cultural milieu as well as a means of communication whose further analysis can provide the meaning given by both the actors to a common event, viz. illness. Moreover on close examination, the conditions of narrative production help us to identify the role of ‘institutions’ in setting the social context in which narrative is embedded. It is within this framework the concept of voice will be used where Voice of illness and Voice of medicine were identified. Different voices distinguish contrasting orientations to the world and to the moral order as each voice realise a particular relationship between the speaker and the world. The above approach of voice not only situates the clinical interaction as a dynamic one where the power of patient is acknowledged but also portrays doctor-patient interaction as an everyday activity of human beings. Thus it is argued that clinical interaction is not merely the two-way communication desired for exchange of information, rather it is the product of the networks in which both the actors function. In other words the interactions are the outcome of the socialisation of doctors (thought styles) and patients’ (life world) about an event (illness) within their respective contexts. This is demonstrated by analysing three clinical interactions during fever care where varied voices are in constant interaction and has a significant role in the process of medical care.
Keywords: Narrative Analysis, Voice of Illness, Voice of medicine, Doctor-Patient Interaction
PhD student, Centre of Social Medicine and Community Health