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In Search of the Good: Narrative Reasoning in Clinical Practice

Cheryl Mattingly
Medical Anthropology Quarterly
Vol. 12, No. 3, Special Collection: Rationality in the Real World: Varieties of Reasoning in Illness and Healing (Sep., 1998), pp. 273-297
Published by: Wiley on behalf of the American Anthropological Association
Stable URL: http://www.jstor.org/stable/649684
Page Count: 25
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In Search of the Good: Narrative Reasoning in Clinical Practice
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Abstract

Based on ethnographic work among North American occupational therapists, I compare two forms of everyday clinical talk. One, "chart talk," conforms to normative conceptions of clinical rationality. The second, storytelling, permeates clinical discussions but has no formal status as a vehicle for clinical reasoning. I argue that both modes of discourse provide avenues for reasoning about clinical problems. However, these discourses construct very different clinical objects and different phenomena to reason about. Further, the clinical problems created through storytelling point toward a more radically distinct conception of rationality than the one underlying biomedicine as it is formally conceived. Clinical storytelling is more usefully understood as a mode of Aristotle's "practical rationality" than the technical rationality of modern (enlightenment) conceptions of reasoning.

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