Illness and Narrative

Abstract

Chronic pain—pain that does not respond to treatment—is problematic not only for the patient but also for the health care provider. Patients with chronic pain represent, to some extent, a health care system’s failure and as a result, they can become both resented and stigmatized by providers; empathy wears out. In medicine, the restitution story—the patient is sick, treated, and gets better—is privileged. It is the story every listener prefers—a story of triumph and success, a story of progress, of restoration, of redemption. But patients with chronic pain cannot tell a restitution story—despite the pressures from their audience, which includes family, friends and health care providers. Yet patients must and will tell their stories and it is in the careful and empathic listening to those stories that care providers can prevent chronic pain from becoming true suffering. Health care providers are trained and poised to take action, to intervene, to do things. In the biomedical sphere, health care providers supply answers to needy patients. However, patients outside a restitution narrative pull providers into a different kind of relationship—one that is non-hierarchical, thus placing the provider in a less controlling and less guarded position. How to recognize and then honour this shift in the patient-provider relationship is not generally included in the medical professional curriculum. In this chapter, I discuss the role narrative plays as a coping tool for patients with chronic pain and their health care providers.